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NPI Code Detail

MEDICARE: DR. TIFFANY ANDERSON TERRELL DO

MEDICARE: DR. TIFFANY ANDERSON TERRELL DO
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
1207Q00000XFamily Medicine Physician20A8506CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00055172OTHERCARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200AXB5060N31OTHERCACAL OPTIMA

General Provider Information

NPI Number : 1629188404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY ANDERSON TERRELL DO
Provider Business Mailing Address
First Line : 15944 LOS SERRANOS COUNTRY CLUB DR STE 110
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-3254
Country : US
Telephone Number : 909-219-9804
Fax Number : 909-219-9806
Provider Business Practice Location Address
First Line : 15944 LOS SERRANOS COUNTRY CLUB DR STE 110
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-3254
Country : US
Telephone Number : 909-219-9804
Fax Number : 909-219-9806
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 03/04/2026

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Directions to “ DR. TIFFANY ANDERSON TERRELL DO” Practice Location

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