Active NPI
Christian Alexander Tagle, DO
- Student in an Organized Health Care Education/Training Program
- Colton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 400 N Pepper Ave
Colton, CA 92324-1801 - Phone
- (909) 580-1000
- NPI assigned
- Jun 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20A22608 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
400 N Pepper Ave
Colton, CA 92324-1801
Mailing address
400 N Pepper Ave
Colton, CA 92324-1801
Other practice location 1
1800 Spring Ridge Dr
Susanville, CA 96130-6100
Phone (303) 390-1940
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A22608 | CA | MD | Internal Medicine Physician |
| 22608 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
dba Target Clinic Medical Associates of Southern California
- Health Maintenance Organization
- Fullerton, CA
- NPI 1336556059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747699200000",
"number": "1578131603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "909-580-1000"
}
],
"practiceLocations": [
{
"address_1": "1800 Spring Ridge Dr",
"address_purpose": "LOCATION",
"city": "Susanville",
"state": "CA",
"postal_code": "961306100",
"country_code": "US",
"telephone_number": "303-390-1940",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAGLE",
"first_name": "CHRISTIAN",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-15",
"last_updated": "2025-05-20",
"certification_date": "2025-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "20A22608",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "441 N Lakeview Ave",
"city": "Anaheim",
"state": "CA",
"country_code": "US",
"postal_code": "928073028",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.