Hata, Tissa R
Hata, Tissa R is an individual health care provider with primary practice located at 200 West Arbor Drive Mc 8201 Ucsd Medical Center, San Diego CA 92103-8201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Hata, Tissa R can be contacted via phone (619) 543-3365.Contact Information
Primary practice address
200 West Arbor Drive Mc 8201 Ucsd Medical Center
San Diego CA 92103-8201
Phone: (619) 543-3365
Fax: (619) 543-3183
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | G63547 | California |
Profile Details
| NPI number | 1558313916 |
|---|---|
| LBN Legal business name | Hata, Tissa R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Jun 8th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558313916 | NPPES |
| California | MEDICAID | 00G635470 |
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