Individual
ELIZABETH P TITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
121 SOTOYOME ST STE 203, SANTA ROSA, CA 95405-4822
(707) 525-6180
(707) 545-1145
Mailing address
121 SOTOYOME ST STE 203, SANTA ROSA, CA 95405-4822
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
213256
MA
208600000X
Surgery Physician
Primary
G148486
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100746
—
MA
Enumeration date
07/27/2006
Last updated
11/11/2021
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