Provider Demographics
NPI:1235371774
Name:TOBIOS, TIFFANY PATRICE
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:PATRICE
Last Name:TOBIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:PATRICE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9315 ARTESIA BLVD
Mailing Address - Street 2:APT 16
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-6226
Mailing Address - Country:US
Mailing Address - Phone:323-219-7231
Mailing Address - Fax:
Practice Address - Street 1:4149 TWEEDY BLVD
Practice Address - Street 2:SUITE J
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-6167
Practice Address - Country:US
Practice Address - Phone:323-567-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61863126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant