Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A113828 | CA |
NPI | 1013292358 |
---|---|
Provider Name | Dr. Tiffany Wong Dote |
First Address | Irvine, CA 92618-3734 |
Second Address | Irvine, CA 92618-3734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2011 |
Last Update Date | 21/12/2021 |