MEDICARE: TIFFANY TOBIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175L00000X	Homeopath	4071	NV

General Provider Information

NPI Number	:	1154759017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY TOBIN

Provider Business Mailing Address
First Line	:	7085 W ANN RD
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3866
Country	:	US
Telephone Number	:	702-463-4400
Fax Number	:	702-463-4401

Provider Business Practice Location Address
First Line	:	7085 W ANN RD
Second Line	:	SUITE 120
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3866
Country	:	US
Telephone Number	:	702-463-4400
Fax Number	:	702-463-4401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2013
Last Update Date	:	10/30/2013

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Directions to “ TIFFANY TOBIN ” Practice Location

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