Provider Demographics
NPI:1134225840
Name:JAMES E. TEARSE, M.D.
Entity type:Organization
Organization Name:JAMES E. TEARSE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:TEARSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-368-3937
Mailing Address - Street 1:1391 WOODSIDE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3574
Mailing Address - Country:US
Mailing Address - Phone:650-368-3937
Mailing Address - Fax:650-368-0270
Practice Address - Street 1:1391 WOODSIDE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-3574
Practice Address - Country:US
Practice Address - Phone:650-368-3937
Practice Address - Fax:650-368-0270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42953207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ09989ZOtherBLUE SHIELD GROUP #
CA180009109OtherJAMES TEARSE MD RRM PIN
CAP00207171OtherHENRY UPTON MD RRM PIN
CAA42953OtherJAMES TEARSE MD LICENCE
CAG23803OtherHENRY UPTON MD LICENSE
CAA86645OtherSANDY CHEN MD LICENSE
CADC7365OtherJAMES E. TEARSE MD RRM GP
CAOOG238030Medicare ID - Type UnspecifiedHENRY UPTON PIN
CAA86645OtherSANDY CHEN MD LICENSE
CAG23803OtherHENRY UPTON MD LICENSE
CAA42953OtherJAMES TEARSE MD LICENCE
CA180009109OtherJAMES TEARSE MD RRM PIN
CAZZZ21710ZMedicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
CA00A429530Medicare ID - Type UnspecifiedPIN JAMES TEARSE MD