Provider Demographics
NPI:1821070681
Name:TESSLER, IRVING R (MD)
Entity Type:Individual
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First Name:IRVING
Middle Name:R
Last Name:TESSLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:50 BELLEFONTAINE ST
Mailing Address - Street 2:STE 405
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3132
Mailing Address - Country:US
Mailing Address - Phone:626-796-9259
Mailing Address - Fax:626-449-8560
Practice Address - Street 1:50 BELLEFONTAINE ST
Practice Address - Street 2:STE 405
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3132
Practice Address - Country:US
Practice Address - Phone:626-796-9259
Practice Address - Fax:626-449-8560
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2013-02-21
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Provider Licenses
StateLicense IDTaxonomies
CAG143072080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G143070Medicaid
CA00G143070Medicaid
A39226Medicare UPIN