Healthcare Provider Details

I. General information

NPI: 1780631309
Provider Name (Legal Business Name): TERESITA TE SAYLOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 04/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4056 ORANGE AVE
LONG BEACH CA
90807-3717
US

IV. Provider business mailing address

6742 HALIFAX DR
HUNTINGTON BEACH CA
92647-2658
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-3328
  • Fax: 562-513-1958
Mailing address:
  • Phone: 714-894-9119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA44632A
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA44632A
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: