DR. BERNARD RICHARD TEGTMEIER (NPI# 1790970648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790970648 |
| Entity Type | Individual |
| Full Name | DR. BERNARD RICHARD TEGTMEIER |
| Credential | PHD |
| Practice Address |
1500 Duarte Rd Duarte CA 91010-3012 |
| Mailing Address |
4312 Fir Ave Seal Beach CA 90740-2905 |
| Practice Telephone | 6263018225 |
| Practice Fax Number | 6263018954 |
| Mailing Telephone | 5624936132 |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247ZC0005X |
Pathology Specialization: Clinical Laboratory Director, Non-physician |
DRI39 | CA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1500 DUARTE RD |
| City | DUARTE |
| State | CA |
| Zip Code | 91010-3012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861498271 | Marwan G Fakih | Internal Medicine | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2005-06-22 |
| 1801403688 | Jia-chi Wang | Medical Genetics | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-09-25 |
| 1053923300 | Ying Moua | Social Worker | 1500 Duarte Rd, Duarte, CA 91010-3000 | 2020-08-18 |
| 1477163814 | Elise Sobotka | Genetic Counselor, MS | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-07-31 |
| 1033728217 | Gabriela Claudia Medrano | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-07-23 |
| 1538783295 | Lynn Kim | Occupational Therapist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-05-29 |
| 1235759887 | Jessica Vuong | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-23 |
| 1073133104 | Edward Thanasombat | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-18 |
| 1285254300 | Tu Nguyen Doan Vuong | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-18 |
| 1093344756 | Amy Marie Mcgovern | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386266849 | Cheyenne King | Student in an Organized Health Care Education/Training Program | 1801 Huntington Drive, Duarte, Ca 91010, Duarte, CA 91010 | 2020-05-07 |
| 1114578028 | Cristian Gonzalez | Case Manager/Care Coordinator | 2250 E Foothill Ave, Pasadena, CA 91010 | 2019-09-23 |
| 1366932378 | Maisie Madrid | Marriage & Family Therapist | 1801 Huntington Drive, Duarte, CA 91010 | 2018-05-15 |
| 1598289571 | Bertha Maria Torres | Social Worker | 938 E. Huntington Drive, Unit A, Duarte, CA 91010 | 2017-08-01 |
| 1598292286 | Sheila Ramirez | Occupational Therapy Assistant | 2302 Citrus View Ave, Duarte, CA 91010 | 2017-05-12 |
| 1982059556 | Patricia Mendoza | Case Manager/Care Coordinator | 2502 E.huntington Dr., Duarte, CA 91010 | 2016-05-02 |
| 1770966178 | Sinziana Dumitra | Surgery | 1500 Durate Road California, Mob L001, Duarte, CA 91010 | 2015-07-02 |
| 1477940161 | Jin Sun L Bitar | Internal Medicine | 1500 Duarte Rd # Wing4, Duarte, CA 91010 | 2015-04-20 |
| 1659625622 | Jeanette Marie Petermann | Nurse Practitioner | 1036 East Huntington Drive, Duarte, CA 91010 | 2012-10-30 |
| 1649534397 | Nathaniel J Khoe Dds. Inc | Dentist | 1016 Huntington Drive, Duarte, CA 91010 | 2012-06-27 |
| Find all providers in zip 91010 | ||||
| Taxonomy Code | 247ZC0005X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Pathology |
| Specialization | Clinical Laboratory Director, Non-physician |
| An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. |
| Notes: Source: National Uniform Claim Committee [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265700660 | Ketevan Gendzekhadze | Pathology | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2011-12-13 |
| 1528277654 | Marilyn Louise Slovak | Pathology | 1500 Duarte Rd, Northwest Building, Room 2255, Duarte, CA 91010-3012 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915888 | Pangea Laboratory LLC | Pathology | 3189 Red Hill Ave Ste D, Costa Mesa, CA 92626-3426 | 2020-06-05 |
| 1851913354 | The Laab LLC | Pathology | 664b W Broadway, Glendale, CA 91204-1008 | 2020-05-07 |
| 1811492028 | Andy Madoyan | Pathology | 1737 E Washington Blvd Ste 5, Pasadena, CA 91104-2772 | 2018-03-28 |
| 1972045110 | Anthony Butch | Pathology | 2122 Granville Ave, Los Angeles, CA 90095-6106 | 2016-11-04 |
| 1730589102 | Dale Ann Schwab | Pathology | 5785 Corporate Ave, Cypress, CA 90630-4726 | 2014-09-03 |
| 1992366843 | Tharanga Niroshini Senaratne | Pathology | 10833 Le Conte Ave, Los Angeles, CA 90095-3075 | 2019-06-21 |
| 1205494218 | Jack Ji | Pathology | 180 Kimball Way, South San Francisco, CA 94080-6218 | 2019-06-04 |
| 1831753839 | Daniel Yue-king Chan | Pathology | 430 S Cataract Ave, San Dimas, CA 91773-2902 | 2019-04-24 |
| 1811295165 | Athena M Cherry | Pathology | 3375 Hillview Ave, Room 2809, Palo Alto, CA 94304-1204 | 2011-03-10 |
| 1386962884 | Gordana Raca | Pathology | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2010-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.