Provider Demographics
NPI:1578729422
Name:TETTEH, BEATRICE (MD)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:TETTEH
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 1:7248 S LAND PARK DR STE 118
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3661
Mailing Address - Country:US
Mailing Address - Phone:916-538-6118
Mailing Address - Fax:916-706-1657
Practice Address - Street 1:7248 S LAND PARK DR STE 118
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3661
Practice Address - Country:US
Practice Address - Phone:916-538-6118
Practice Address - Fax:916-706-1657
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112691208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics