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Organization

GARY M TEARSTON MD A MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GARY M TEARSTON M.D. (PRESIDENT)
(310) 659-5502
Entity
Organization

Contact information

Practice address
2122 CENTURY PARK LN, UNIT 207, LOS ANGELES, CA 90067-3304
(310) 659-5502
(310) 659-7639
Mailing address
PO BOX 18587, BEVERLY HILLS, CA 90209-4587
(310) 659-5502
(310) 659-7639

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G15838
CA

Other

Enumeration date
03/21/2007
Last updated
03/11/2009
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