Individual
THEODORE M TEACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
26691 PLAZA, SUITE 235, MISSION VIEJO, CA 92691-6329
(949) 364-9054
(949) 364-6171
Mailing address
26691 PLAZA, SUITE 235, MISSION VIEJO, CA 92691-6329
(949) 364-9054
(949) 364-6171
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G45898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ57376Z
BLUE SHIELD
CA
Enumeration date
07/23/2006
Last updated
01/30/2024
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