Individual
DR. THEODORE H TERUYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11370 ANDERSON ST, SUITE 2100, LOMA LINDA, CA 92354-3450
(909) 558-2126
(909) 558-2401
Mailing address
11370 ANDERSON ST, SUITE 2100, LOMA LINDA, CA 92354-3450
(909) 558-2126
(909) 558-2401
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
10795
HI
2086S0129X
Vascular Surgery Physician
10795
HI
2086S0129X
Vascular Surgery Physician
Primary
A71912
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000249011
HMSA
—
01
—
517420
HMA NEW
—
01
—
55759801
ALOHACARE
—
05
—
55759801
—
HI
01
—
990287995
UHA
—
01
—
MD10795
MDX
—
Enumeration date
11/20/2006
Last updated
06/29/2023
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