Individual
ROBERT W TEVENDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
290 N WAYTE LN, FRESNO, CA 93701-2124
(559) 459-5700
(559) 459-3832
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A65065
CA
207R00000X
Internal Medicine Physician
A65065
CA
208M00000X
Hospitalist Physician
Primary
A65065
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A650650
—
CA
Enumeration date
08/25/2006
Last updated
09/26/2018
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