MEDICARE: BEATRICE TETTEH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A112691	CA

General Provider Information

NPI Number	:	1578729422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRICE TETTEH M.D.

Provider Business Mailing Address
First Line	:	7248 S LAND PARK DR STE 118
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3661
Country	:	US
Telephone Number	:	916-538-6118
Fax Number	:	916-706-1657

Provider Business Practice Location Address
First Line	:	7248 S LAND PARK DR STE 118
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3661
Country	:	US
Telephone Number	:	916-538-6118
Fax Number	:	916-706-1657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	08/05/2019

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