Provider Demographics
NPI:1578298121
Name:TEJERO-BINGHAM, TESSA ISABELLA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TESSA
Middle Name:ISABELLA
Last Name:TEJERO-BINGHAM
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6459 ZUMA VIEW PL
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-4494
Mailing Address - Country:US
Mailing Address - Phone:310-266-3326
Mailing Address - Fax:
Practice Address - Street 1:23644 VANOWEN ST
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2443
Practice Address - Country:US
Practice Address - Phone:818-887-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2024-01-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant