Individual
EDEN ANDEBERHAN TEFERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
10301 GARVEY AVE STE 100, EL MONTE, CA 91733-2180
(626) 448-0468
Mailing address
16028 BEGONIA AVE, CHINO, CA 91708-9249
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA17074
PA LICENSE NO
CA
Enumeration date
05/23/2007
Last updated
02/11/2015
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