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General NPI Number Information
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NPI Number | 1932553492
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Entity Type | Individual
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Provider Name | TIFFANY TYLER PHARM D
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Gender | Female
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 1575 W PACHECO BLVD
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City | LOS BANOS
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State | CA
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Zip | 93635-8505
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Country | US
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Telephone | 209-826-9653
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Fax | 209-826-8013
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Provider Business Mailing Address
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Address Line | 1575 W PACHECO BLVD
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City | LOS BANOS
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State | CA
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Zip | 93635-8505
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Country | US
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Telephone | 209-826-9653
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Fax | 209-826-8013
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 72701
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15827
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License Number State | OK
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