Provider Demographics
NPI:1376842864
Name:AMAN, TIFFANY H (MD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:H
Last Name:AMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3975 JACKSON ST
Mailing Address - Street 2:STE 207
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3901
Mailing Address - Country:US
Mailing Address - Phone:951-352-2092
Mailing Address - Fax:951-352-1913
Practice Address - Street 1:3975 JACKSON ST
Practice Address - Street 2:STE 207
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3901
Practice Address - Country:US
Practice Address - Phone:951-352-2092
Practice Address - Fax:951-352-1913
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128438208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics