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Individual

DR. TANYA AUDREY MARGARET DEPORTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, PHD, MPH

Contact information

Practice address
26001 REDLANDS BLVD, REDLANDS, CA 92373-7762
(909) 825-7084
Mailing address
PO BOX 315, WILDOMAR, CA 92595-0315

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
145547
CA

Other

Enumeration date
12/16/2016
Last updated
08/17/2020
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