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General NPI Number Information
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NPI Number | 1871832287
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Entity Type | Individual
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Provider Name | EDWARD ROBERT TEARE APRN-BC
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Gender | Male
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 1144 65TH ST STE F
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City | OAKLAND
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State | CA
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Zip | 94608-1053
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Country | US
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Telephone | 510-929-1400
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Fax | 510-929-1414
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Provider Business Mailing Address
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Address Line | 1144 65TH ST STE F
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City | OAKLAND
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State | CA
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Zip | 94608-1053
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Country | US
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Telephone | 510-929-1400
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Fax | 510-929-1414
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN001488
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A0213013
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95003095
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License Number State | CA
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