Individual
PROF. AMI CHIRSTINE TEODORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLP-PA
Contact information
Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3238
(510) 601-3904
Mailing address
500 UNIVERSITY AVE STE 100, SACRAMENTO, CA 95825-6527
(916) 437-0570
(916) 437-0470
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19708
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA19708
PAC LICENSE
CA
Enumeration date
05/15/2008
Last updated
01/11/2021
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