MEDICARE: KALEAB TESSEMA

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	2084P0800X	Psychiatry Physician	A204453	CA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1952009003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEAB TESSEMA

Provider Business Mailing Address
First Line	:	760 WESTWOOD PLZ STE 37-384
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-5055
Country	:	US
Telephone Number	:	310-206-6721
Fax Number	:

Provider Business Practice Location Address
First Line	:	760 WESTWOOD PLZ STE 37-384
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-5055
Country	:	US
Telephone Number	:	310-206-6721
Fax Number	:

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

Provider Enumeration Date	:	02/17/2023
Last Update Date	:	12/08/2025

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Directions to “ KALEAB TESSEMA ” Practice Location

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