Theodore M Teacher Md Apc | |
26691 Plaza Suite 235 Mission Viejo CA 92691-6329 | |
(949) 364-9054 | |
(949) 364-6171 |
Full Name | Theodore M Teacher Md Apc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 26691 Plaza, Mission Viejo, California |
Authorized Official Name and Position | Ruth E Eastham (MGR) |
Authorized Official Contact | 9493649054 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Theodore M Teacher Md Apc 26691 Plaza Suite 235 Mission Viejo CA 92691-6329 Ph: (949) 364-9054 | Theodore M Teacher Md Apc 26691 Plaza Suite 235 Mission Viejo CA 92691-6329 Ph: (949) 364-9054 |
NPI Number | 1255520169 |
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Provider Enumeration Date | 10/16/2007 |
Last Update Date | 01/30/2024 |
Certification Date | 01/30/2024 |
Medicare PECOS PAC ID | 7517994478 |
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Medicare Enrollment ID | O20050721000838 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255520169 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (California) | Primary |
Provider Name | Theodore M Teacher |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1871514729 PECOS PAC ID: 1850566688 Enrollment ID: I20111206000830 |
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