Provider Demographics
NPI:1083255707
Name:TUTTO, MARIANNE CHARLOTTE (RPH)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:CHARLOTTE
Last Name:TUTTO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2729 ANGELL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-2104
Mailing Address - Country:US
Mailing Address - Phone:619-379-9877
Mailing Address - Fax:858-822-6087
Practice Address - Street 1:3855 HEALTH SCIENCES DR RM 1064A
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-1503
Practice Address - Country:US
Practice Address - Phone:858-822-6083
Practice Address - Fax:858-822-6087
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479121835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology