Tatiana Marie Mamantov, MD

NPI #1629069059 in Castro Valley, California

Provider Information

NPI Number: 1629069059
Entity Type: Individual
Name: Tatiana Marie Mamantov, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Emergency Medicine
Credential: MD
Enumeration Date: Nov 3, 2005
Last Updated: Jul 30, 2008

Practice Location

Address: 20103 LAKE CHABOT RD
City: Castro Valley
State: California
ZIP Code: 94546-5341
Phone: (209) 342-2300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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