Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tatiana Marie Mamantov, MD

Individual provider Emergency Medicine Physician · NPI 1629069059

Tatiana Marie Mamantov, MD is an Emergency Medicine in Castro Valley, California. Graduated from East Tennessee State University Quillen College of Medicine in 1984, 42 years ago. Practices with Sharp Rees-Stealy Medical Group Inc, a 874-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
42
Trained at
East Tennessee State University Quillen College of Medicine
Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

20103 Lake Chabot Rd
Castro Valley, CA 94546-5341
Phone: (209) 342-2300
Fax: (209) 524-4240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence G85179 (CA)

Record details

NPI number1629069059
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 3, 2005
Last updated in NPPESJuly 30, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Also practisesMEDICAL TOXICOLOGY
Medical schoolEAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Graduated 1984 (42 years in practice)
Group practice Sharp Rees-Stealy Medical Group Inc — 874 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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