Individual
ERIC THEODORE TEACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11234 ANDERSON ST, HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354-2804
(909) 558-8131
Mailing address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(949) 545-8386
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A113183
CA
Other
Enumeration date
04/08/2009
Last updated
07/16/2012
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