Healthcare Provider Details

I. General information

NPI: 1346493491
Provider Name (Legal Business Name): DAVID TEICHEIRA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2008
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 ALHAMBRA BLVD SUITE 205
SACRAMENTO CA
95816-3847
US

IV. Provider business mailing address

PO BOX 207
DAVIS CA
95617-0207
US

V. Phone/Fax

Practice location:
  • Phone: 916-923-0900
  • Fax: 916-923-0901
Mailing address:
  • Phone: 530-923-0900
  • Fax: 530-923-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberG60747
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID PAUL TEICHEIRA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 916-923-0900