Provider Demographics
NPI:1013915594
Name:TESSIER, ADLA (MD)
Entity type:Individual
Prefix:DR
First Name:ADLA
Middle Name:
Last Name:TESSIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 22128
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92192-2128
Mailing Address - Country:US
Mailing Address - Phone:619-997-8861
Mailing Address - Fax:858-452-0152
Practice Address - Street 1:4060 FAIRMOUNT AVE
Practice Address - Street 2:FAMILY PRACTICE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105
Practice Address - Country:US
Practice Address - Phone:619-255-9155
Practice Address - Fax:619-795-9849
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA 51666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073144432OtherAMERICAN BOARD OF FAMILY MEDICINE