Individual
TATIANA M TRETIAKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3115 REDHILL AVE, COSTA MESA, CA 92626
(714) 850-8408
(714) 850-8587
Mailing address
3115 REDHILL AVE, COSTA MESA, CA 92626
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A63465
CA
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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