Putue Teh, PA is a medicare enrolled "Physician Assistant" physician in Clearlake, California. His current practice location is
15230 Lakeshore Dr, Clearlake, California. You can reach out to his office (for appointments etc.) via phone at
(707) 995-4545.
Putue Teh is licensed to practice in California (license number 363A00000X) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1235812264.
Physician's Profile
| Full Name | Putue Teh |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 15230 Lakeshore Dr, Clearlake, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1235812264
- Provider Enumeration Date: 08/08/2023
- Last Update Date: 08/08/2023
Medicare PECOS Information:
- PECOS PAC ID: 1658715958
- Enrollment ID: I20240214003002
Medical Identifiers
Medical identifiers for Putue Teh such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235812264 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 208000000X (California) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2084P0800X (California) | Secondary |
| 207R00000X | Internal Medicine | 207R00000X (California) | Secondary |
| 363A00000X | Physician Assistant | 363A00000X (California) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | 390200000X (California) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Putue Teh is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Putue Teh, PA
2081 Expedition Way,
Sacramento, CA 95832-1262
Ph: (707) 803-1427 | Putue Teh, PA
15230 Lakeshore Dr,
Clearlake, CA 95422-8107
Ph: (707) 995-4545 |
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