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General NPI Number Information
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NPI Number | 1760904593
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Entity Type | Organization
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Legal Business Name | TENG MEDICAL FOUNDATION PC
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/13/2017
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Provider Practice Location Address
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Address Line | 831 STERLING PKWY STE 110
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City | LINCOLN
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State | CA
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Zip | 95648-7323
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Country | US
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Telephone | 916-253-9898
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 434
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City | LEWISTON
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State | ID
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Zip | 83501-0434
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Country | US
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Telephone | 916-253-9898
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHUNWEN TENG
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Credential | DO
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Telephone | 916-253-9898
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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 |
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License Number State |
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