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General NPI Number Information
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NPI Number | 1679250765
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Entity Type | Individual
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Provider Name | TIFFANY ROSE DUFFY DC
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Gender | Female
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Dates
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Enumeration Date | 06/29/2023
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 16490 PASEO DEL SUR STE 115
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City | SAN DIEGO
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State | CA
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Zip | 92127-4203
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Country | US
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Telephone | 858-524-1091
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Fax | 858-524-1033
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Provider Business Mailing Address
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Address Line | 1619 COLUMBUS RD
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-4916
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Country | US
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Telephone | 760-271-9712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 36654
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License Number State | CA
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