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NPI Code Detail

MEDICARE: MINDI TENGAN

MEDICARE: MINDI TENGAN
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
1235Z00000XSpeech-Language PathologistSP23152CA

General Provider Information

NPI Number : 1770983322
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINDI TENGAN
Provider Business Mailing Address
First Line : PO BOX 768787
Second Line :
City : ROSWELL
State : GA
Zip : 30076-8210
Country : US
Telephone Number : 818-241-6780
Fax Number : 818-241-6853
Provider Business Practice Location Address
First Line : 5312 BOLSA AVE STE 105
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92649-1060
Country : US
Telephone Number : 855-295-3276
Fax Number : 818-241-6853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2014
Last Update Date : 03/10/2020

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Directions to “ MINDI TENGAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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