Provider Demographics
NPI:1780631309
Name:SAYLOR, TERESITA TE (MD)
Entity Type:Individual
Prefix:MRS
First Name:TERESITA
Middle Name:TE
Last Name:SAYLOR
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 1:6742 HALIFAX DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2658
Mailing Address - Country:US
Mailing Address - Phone:714-894-9119
Mailing Address - Fax:
Practice Address - Street 1:4056 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3717
Practice Address - Country:US
Practice Address - Phone:562-424-3328
Practice Address - Fax:562-513-1958
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44632A173000000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A446320Medicaid
CA00A446320Medicaid
CAA44632AMedicare ID - Type Unspecified