Provider Demographics
NPI:1609555796
Name:GEMECHIS, TESHAGRE
Entity Type:Individual
Prefix:
First Name:TESHAGRE
Middle Name:
Last Name:GEMECHIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2492 GOLZIO CT APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-2535
Mailing Address - Country:US
Mailing Address - Phone:720-249-9012
Mailing Address - Fax:
Practice Address - Street 1:2492 GOLZIO CT APT 4
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-2535
Practice Address - Country:US
Practice Address - Phone:720-249-9012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)