Provider Demographics
NPI:1265420806
Name:TIORAN, TERESA A (DO)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:TIORAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 990208
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-0208
Mailing Address - Country:US
Mailing Address - Phone:530-212-0073
Mailing Address - Fax:
Practice Address - Street 1:2701OLD EUREKA WAY
Practice Address - Street 2:SUITE 1-F
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-241-4250
Practice Address - Fax:530-241-4260
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7113207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0014100Medicaid
CAGR0014100Medicaid
CAG64178Medicare UPIN