Provider Demographics
NPI:1457748527
Name:TEDLA, SARA G (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:G
Last Name:TEDLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-5948
Mailing Address - Fax:650-723-3045
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-725-6344
Practice Address - Fax:650-736-1523
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1479082085R0202X
GA912432085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology