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Individual
TIFFANY LA
Active
Individual
TIFFANY LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34249TLG
CA
Other
Enumeration date
04/13/2018
Last updated
04/28/2023
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