Provider Demographics
NPI:1801394671
Name:OREN TESSLER MD LLC
Entity Type:Organization
Organization Name:OREN TESSLER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VIRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-262-0720
Mailing Address - Street 1:3219 E CAMELBACK RD PMB 581
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2307
Mailing Address - Country:US
Mailing Address - Phone:480-561-6185
Mailing Address - Fax:360-925-3470
Practice Address - Street 1:3219 E CAMELBACK RD PMB 581
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2307
Practice Address - Country:US
Practice Address - Phone:480-561-6185
Practice Address - Fax:360-925-3470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ55056208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty