Provider Demographics
NPI:1427386911
Name:NEUMANN, TATIANA ALEXANDROVNA (DO)
Entity Type:Individual
Prefix:DR
First Name:TATIANA
Middle Name:ALEXANDROVNA
Last Name:NEUMANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 MORENA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3703
Mailing Address - Country:US
Mailing Address - Phone:858-248-3033
Mailing Address - Fax:619-275-2426
Practice Address - Street 1:1675 MORENA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3703
Practice Address - Country:US
Practice Address - Phone:858-248-3033
Practice Address - Fax:619-275-2426
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2014-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A 10723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine