MEDICARE: TERESA CHUN FLORY M.D,

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	207L00000X	Anesthesiology Physician	G56250	CA

General Provider Information

NPI Number	:	1891711339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA CHUN FLORY M.D,

Provider Business Mailing Address
First Line	:	1535 FARMERS LN 335
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95405-7525
Country	:	US
Telephone Number	:	707-792-2800
Fax Number	:	844-729-3524

Provider Business Practice Location Address
First Line	:	1128 W EL CAMINO REAL
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-2518
Country	:	US
Telephone Number	:	650-964-3200
Fax Number	:

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

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	01/27/2020

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