Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A128926 | CA |
NPI | 1023337466 |
---|---|
Provider Name | Tiffany Tan Sison |
First Address | Tucson, AZ 85723-0001 |
Second Address | Tucson, AZ 85723-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2010 |
Last Update Date | 03/12/2014 |