MEDICARE: TEEMED CORP

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	207Q00000X	Family Medicine Physician	G45100	CA

General Provider Information

NPI Number	:	1831321868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEEMED CORP

Provider Business Mailing Address
First Line	:	15810 GALE AVE
Second Line	:	STE 157
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15810 GALE AVE
Second Line	:	STE 157
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-1601
Country	:	US
Telephone Number	:	626-548-1504
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	PATRICK S THOMPSON
Credential	:
Telephone Number	:	626-548-1504

Provider Enumeration Date	:	08/08/2009
Last Update Date	:	10/16/2009

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Directions to “TEEMED CORP ” Practice Location

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