Individual
JAMES R TIEGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2951
(310) 479-1459
Mailing address
1516 COTNER AVE, LOS ANGELES, CA 90025-3303
(310) 445-2951
(310) 479-1459
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C36523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C365230
BLUE SHIELD
CA
05
—
00C365230
—
CA
Enumeration date
06/14/2006
Last updated
11/29/2023
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