Basic Information
| Provider Information | |||||||||
| NPI: | 1710903133 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPIRTOS | ||||||||
| FirstName: | TATIANA | ||||||||
| MiddleName: | WOROBEY | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 WHIPPLE AVE | ||||||||
| Address2: | #135 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940622843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503665594 | ||||||||
| FaxNumber: | 6503666352 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 WHIPPLE AVE | ||||||||
| Address2: | #135 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940622843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503665594 | ||||||||
| FaxNumber: | 6503666352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 09/16/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | G45093 | CA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | ZZZ23195Z | 01 | CA | MEDICARE GROUP | OTHER | 00G450934 | 01 | CA | MEDICARE PIN | OTHER |