Provider Demographics
NPI:1811382559
Name:TENG, POLLY FU (MD)
Entity Type:Individual
Prefix:DR
First Name:POLLY
Middle Name:FU
Last Name:TENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:POLLY
Other - Middle Name:BO-YI
Other - Last Name:FU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4150 V ST STE G400
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1460
Mailing Address - Country:US
Mailing Address - Phone:916-734-3730
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST STE B0100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-2737
Practice Address - Fax:916-734-2292
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA146789207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program