Individual
MARCO TEJEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2989 CROOKED CREEK DR, DIAMOND BAR, CA 91765-3408
(951) 675-0191
Mailing address
9025 COLORADO AVE, RIVERSIDE, CA 92503-2157
(951) 688-3636
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT5705
CA
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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