Individual
DR. KENNETH MEGUMI TESHIMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
24331 EL TORO ROAD, SUITE 370, LAGUNA WOODS, CA 92637-3104
(949) 951-9207
(949) 588-8826
Mailing address
24331 EL TORO ROAD, SUITE 370, LAGUNA WOODS, CA 92637-3104
(949) 951-9207
(949) 588-8826
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000021929
MEDICARE EDI #
CA
05
—
000E21030
—
CA
Enumeration date
05/07/2007
Last updated
09/04/2012
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