Provider Demographics
NPI:1952665036
Name:TEK, ROTANA STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROTANA
Middle Name:STEVEN
Last Name:TEK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:468 N CAMDEN DR STE 5500
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4507
Mailing Address - Country:US
Mailing Address - Phone:213-334-4111
Mailing Address - Fax:213-335-5001
Practice Address - Street 1:800 FAIRMOUNT AVE STE 323
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3155
Practice Address - Country:US
Practice Address - Phone:213-334-4111
Practice Address - Fax:213-335-5001
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2402207R00000X
FLTPOS216207R00000X
CAA13698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA591579Medicaid
CACA142663Medicare UPIN