Smart, Tiffany Tyler

Smart, Tiffany Tyler is an individual health care provider with primary practice located at 590 Harbor St , Morro Bay CA 93442-1904. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Smart, Tiffany Tyler can be contacted via phone (805) 772-1269.

Contact Information

Primary practice address
590 Harbor St Morro Bay CA 93442-1904
Fax: (805) 772-2172
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT12647 California

Profile Details

NPI number 1619948304
LBN Legal business name Smart, Tiffany Tyler
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Jan 29th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619948304 NPPES
California MEDICAID SD01264701

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