Healthcare Provider Details

I. General information

NPI: 1265420806
Provider Name (Legal Business Name): TERESA A TIORAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701OLD EUREKA WAY SUITE 1-F
REDDING CA
96001
US

IV. Provider business mailing address

PO BOX 990208
REDDING CA
96099-0208
US

V. Phone/Fax

Practice location:
  • Phone: 530-241-4250
  • Fax: 530-241-4260
Mailing address:
  • Phone: 530-212-0073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number20A7113
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: