Healthcare Provider Details

I. General information

NPI: 1962319822
Provider Name (Legal Business Name): TEBI MEDICAL CA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 UNION PARK WAY
ELK GROVE CA
95624-2786
US

IV. Provider business mailing address

9090 UNION PARK WAY
ELK GROVE CA
95624-2786
US

V. Phone/Fax

Practice location:
  • Phone: 877-340-1697
  • Fax: 877-340-1697
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERI BILHARTZ
Title or Position: OWNER
Credential: DO
Phone: 877-340-1697