Healthcare Provider Details

I. General information

NPI: 1447308515
Provider Name (Legal Business Name): TESLA MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 11/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 MASIONETTE DR
HANFORD CA
93230
US

IV. Provider business mailing address

171 MASIONETTE DR
HANFORD CA
93230
US

V. Phone/Fax

Practice location:
  • Phone: 559-783-1181
  • Fax: 559-783-2084
Mailing address:
  • Phone: 559-783-1181
  • Fax: 559-783-2084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RITA NYE
Title or Position: BILLING SUPER
Credential:
Phone: 559-783-1181