Individual
TIFFANY LAINE KINGSBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TECHNICIANS
Contact information
Practice address
1 EAGLE RD BLDG 1, ALAMEDA, CA 94501-5100
(510) 437-3582
(510) 437-3300
Mailing address
USCG HQ COMDT (CG-1122), 2100 SECOND ST., SW, WASHINGTON, DC 20593-0001
(202) 475-5181
(202) 475-5909
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/21/2006
Last updated
10/04/2012
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