Tiffany Louise Moore, O.D.
Optometrist in Santa Rosa, CA. Individual provider (NPI-1).
NPI number1417200288
StatusActive
Last updated in NPPESJun 10, 2015
Details
- NPI
- 1417200288
- Entity type
- Individual (NPI-1)
- Name
- Tiffany Louise Moore
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 18, 2012
- Last updated
- Jun 10, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 15230 | CA | Yes |
Practice location
800 4th StSanta Rosa, CA 95404-4505
Phone 707-542-1554
Mailing address
2024 Montecito AveSanta Rosa, CA 95404
United States Minor Outlying Islands
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