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Individual

TIFFANY GILLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
34102 LA PLZ STE C, DANA POINT, CA 92629-6524
(949) 354-1020
Mailing address
33601 RISING TIDE CT, DANA POINT, CA 92629-1924
(949) 354-1020

Taxonomy

Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary

Other

Enumeration date
12/09/2025
Last updated
01/26/2026
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