Most Relevant Information
Provider Data
| NPI Number: | 1003452905 |
| Provider Name: | OMAR TEJADA |
| Entity Type: | Individual |
| Taxonomy Code: | 261QM0801X |
| Specialty: | Clinic/Center |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/26/2019 |
| Last Updated: | 11/26/2019 |
Provider Practice Location
2640 BRESLAUER WAY
REDDING
CA
960014246
Practice Location Phone/Fax
| Phone: | 5302255252 |
| Fax: |
Provider Mailing Location
2640 BRESLAUER WAY
REDDING
CA
960014246
Provider Mailing Phone/Fax
| Phone: | 5307105838 |
| Fax: |