Provider Demographics
NPI:1447259965
Name:TESKE, THOMAS E (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:E
Last Name:TESKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:852 E DANENBERG DR
Mailing Address - Street 2:
Mailing Address - City:EL CENTRO
Mailing Address - State:CA
Mailing Address - Zip Code:92243-8511
Mailing Address - Country:US
Mailing Address - Phone:760-344-9951
Mailing Address - Fax:760-344-1629
Practice Address - Street 1:852 E DANENBERG DR
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-8511
Practice Address - Country:US
Practice Address - Phone:760-352-2257
Practice Address - Fax:760-352-4579
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2019-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG655182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G655181Medicaid
CA0G55181Medicare PIN
CAE08441Medicare UPIN
CA00G655181Medicaid