Provider Demographics
NPI:1275115867
Name:TIATROS INC.
Entity Type:Organization
Organization Name:TIATROS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:CERRONE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MBA, JD
Authorized Official - Phone:415-378-2838
Mailing Address - Street 1:330 MISSION BAY BLVD. N.
Mailing Address - Street 2:SUITE 113
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158
Mailing Address - Country:US
Mailing Address - Phone:415-378-2838
Mailing Address - Fax:
Practice Address - Street 1:330 MISSION BAY BLVD. N.
Practice Address - Street 2:SUITE 113
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158
Practice Address - Country:US
Practice Address - Phone:415-378-2838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date: