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General NPI Number Information
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NPI Number | 1265580112
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Entity Type | Individual
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Provider Name | TERI LYNN KUNIN-RIDA MD
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 165 S 1ST ST FAMILY PRACTICE
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City | EL CAJON
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State | CA
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Zip | 92019-4795
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Country | US
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Telephone | 619-312-0347
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Fax | 619-749-5480
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Provider Business Mailing Address
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Address Line | 4060 FAIRMOUNT AVE
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City | SAN DIEGO
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State | CA
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Zip | 92105-1608
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Country | US
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Telephone | 619-280-4213
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Fax | 619-280-3545
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G080071
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G80071
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License Number State | CA
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