MEDICARE: DONALD P TECCA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G45791	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	952818055	OTHER	CA	TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235163163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD P TECCA MD

Provider Business Mailing Address
First Line	:	7830 CLAIREMONT MESA BLVD
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1619
Country	:	US
Telephone Number	:	858-268-1111
Fax Number	:	858-268-0761

Provider Business Practice Location Address
First Line	:	7830 CLAIREMONT MESA BLVD
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1619
Country	:	US
Telephone Number	:	858-268-1111
Fax Number	:	858-268-0761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	02/27/2018

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Directions to “ DONALD P TECCA MD” Practice Location

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