Basic Information
| Provider Information | |||||||||
| NPI: | 1720291222 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KURMANALIEVA | ||||||||
| FirstName: | TAMARA | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 70180 | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925130180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513543216 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9939 MAGNOLIA AVE | ||||||||
| Address2: | |||||||||
| City: | RIVERSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925033528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516878802 | ||||||||
| FaxNumber: | 9516872250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 06/29/2017 | ||||||||
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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 | 207Q00000X | A98504 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.