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NPI Code Detail

MEDICARE: JOSEPH TAN TESSLER DO

MEDICARE: JOSEPH TAN TESSLER DO
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
1390200000XStudent in an Organized Health Care Education/Training ProgramTX
2208100000XPhysical Medicine & Rehabilitation Physician20547CA
3390200000XStudent in an Organized Health Care Education/Training Program
4390200000XStudent in an Organized Health Care Education/Training ProgramNM

General Provider Information

NPI Number : 1700383528
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH TAN TESSLER DO
Provider Business Mailing Address
First Line : 5885 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-1863
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5885 BROCKTON AVE
Second Line :
City : RIVERSIDE
State : CA
Zip : 92506-1863
Country : US
Telephone Number : 800-270-5016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 12/25/2023

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