Individual
CARL E TJERANDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2175 ROSALINE AVE, REDDING, CA 96001-2509
(530) 225-6000
(818) 587-2493
Mailing address
2100 POWELL ST, STE 900, EMERYVILLE, CA 94608-1844
(510) 851-7423
(510) 879-9120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA18091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00291750
RAILROAD MEDICARE
CA
05
—
PA18091
—
CA
Enumeration date
06/25/2006
Last updated
04/06/2017
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