Active NPI
Tasha Manternach, M.D.
- Dermatology Physician
- Oceanside, CA
National Provider Identifier
1750360491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- C52681
- Practice address
- 1300 Rancho del Oro Rd
Oceanside, CA 92056-1729 - Phone
- (760) 828-2093
- NPI assigned
- Jan 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | C52681 | CA | Primary |
Addresses
Primary practice location
1300 Rancho del Oro Rd
Oceanside, CA 92056-1729
Mailing address
141 Athena St
Encinitas, CA 92024-2026
Phone (760) 828-2093
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C52681 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1750360491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 ATHENA ST",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920242026",
"telephone_number": "760-828-2093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 RANCHO DEL ORO RD",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920561729",
"telephone_number": "760-828-2093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTERNACH",
"first_name": "TASHA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-11",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "C52681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.