Individual
MARY TIFFANY T MUNOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01113
MEDICAID
CA
Enumeration date
08/03/2021
Last updated
05/08/2025
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