TATIANA MARIE MAMANTOV

CASTRO VALLEY, CA
NPI1629069059
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: CA  G85179)
Enumeration Date2005-11-03
Last Update Date2008-07-30
Business Address
-- TATIANA MARIE MAMANTOV MD
20103 LAKE CHABOT RD
CASTRO VALLEY, CA 94546-5341
Phone number: 209-342-2300
Mailing Address
-- TATIANA MARIE MAMANTOV MD
4301 NORTHSTAR WAY
MODESTO, CA 95356-9262
Phone number: 209-342-2300
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