Tilksew A Tedla (NPI# 1356856132, PAC ID# 4789937806) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1356856132 |
| PAC ID by PECOS | 4789937806 |
| Professional Enrollment ID | I20190806000484 |
| Full Name | Tilksew A Tedla |
| Organization Legal Name | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| Address |
349 E Bullard Ave Suite 105 Fresno CA 93710-5298 |
| Phone Number | 5592721295 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8426028069 |
| Number of Group Practice Members | 46 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050192 | ADVENTIST HEALTH REEDLEY |
| Address | Phone | Organization |
|---|---|---|
| 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 | 5592721295 | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| 3751 E Shields Ave, Fresno, CA 93726-7029 | 5592721295 | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| Organization Legal Name | LAGS SPINE AND SPORTSCARE MEDICAL CENTERS INC |
| Physicians | 47 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael They | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 3550 Q St, Bakersfield, CA 93301-1645 |
| Manli Huang | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 945 Blanco Cir, Suite A, Salinas, CA 93901-4421 |
| Analene Z Cesar | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 510 W 25th St, Merced, CA 95340-2802 |
| Brianna L Hoffmann | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 169 Ne 102nd Ave, Portland, OR 97220-4169 |
| Femi B Obanor | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Krisztina Herrera | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 4080 Loma Vista Rd, Suite F, Ventura, CA 93003-1811 |
| Matthew Hadilaksono | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 801 E Chapel St, Suite 1, Santa Maria, CA 93454-4607 |
| Kendra N Brown Walker | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 2651 S C St, Suite 200, Oxnard, CA 93033-3560 |
| Heliodoro M Magana | Physician Assistant | Lags Spine and Sportscare Medical Centers Inc | 218 N I St, Lompoc, CA 93436-0909 |
| Olivia A Seibenick | Physician Assistant | Lags Spine and Sportscare Medical Centers Inc | 2362 N Oxnard Blvd, Oxnard, CA 93036-2053 |
| Street Address |
349 E BULLARD AVE SUITE 105 |
| City | FRESNO |
| State | CA |
| Zip | 93710-5298 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Femi B Obanor | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Upkar Kaur Badhesha | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Rita Obiajulum Enunwa | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Jane Wang | Physical Medicine and Rehabilitation | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Christiana Ngozi Okonkwo | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Hope Lo | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Felista Anugom | Nurse Practitioner | Lags Spine and Sportscare Medical Centers Inc | 349 E Bullard Ave, Suite 105, Fresno, CA 93710-5298 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alexandra Debenedetto | Chiropractic | 1706 E Bullard St, Suite 101, Fresno, CA 93710 | |
| Perminder J S Bhatia | Neurology | Neuro-pain Medical Center Inc | 736 E Bullard, Suite 101, Fresno, CA 93710 |
| David Nicholas Baker | Physician Assistant | Neuro-pain Medical Center Inc | 736 E Bullard, Suite 101, Fresno, CA 93710 |
| Robert P Hansen | Undefined Physician Type (specify) | 6721 N Willow Ave, Suite 101, Fresno, CA 93710-0000 | |
| Paul Ky | Physical Medicine and Rehabilitation | 6769 N Fresno St, Suite 206, Fresno, CA 93710-3715 | |
| Pa Heu | Family Medicine | 6769 N Fresno St, Suite 204, Fresno, CA 93710-3715 | |
| Jane F Kardashian | Dermatology | 6769 N Fresno St, Fresno, CA 93710-3715 | |
| Ogonna I Onyeje | Internal Medicine | 6769 N Fresno St, Suite 201, Fresno, CA 93710-3715 | |
| Ifeatu Emmanuel Ekelem | Family Practice | Impact Medical Group Professional Corporation | 6769 N Fresno St, Suite 201, Fresno, CA 93710-3715 |
| Aryan Pazirandeh | Optometry | David B Kaye, Md, Inc | 6767 N Fresno St, Fresno, CA 93710-3739 |
| Find all physicians in zip 93710 | |||
| City | FRESNO |
| Zip Code | 93710 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | FRESNO + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Tilksew A Tedla.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.