Provider Demographics
NPI:1124036074
Name:CLAUS, TERESA ANN (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ANN
Last Name:CLAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4835 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403
Mailing Address - Country:US
Mailing Address - Phone:818-905-1920
Mailing Address - Fax:818-905-1932
Practice Address - Street 1:4835 VAN NUYS BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:818-905-1920
Practice Address - Fax:818-905-1932
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77444207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G774440OtherBLUE SHIELD
G27973Medicare UPIN
00G774440OtherBLUE SHIELD
G77444Medicare ID - Type Unspecified