Mark Tiedeman (NPI# 1730478066, PAC ID# 4082994116) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1730478066 |
| PAC ID by PECOS | 4082994116 |
| Professional Enrollment ID | I20161207002413 |
| Full Name | Mark Tiedeman |
| Organization Legal Name | ZEOLLA PHYSICAL THERAPY INC |
| Address |
5927 Kanan Rd Agoura Hills CA 91301-1688 |
| Phone Number | 8188890158 |
| Gender | M |
| Graduation Year | 2001 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 8224292776 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 5927 Kanan Rd, Agoura Hills, CA 91301-1688 | 8188890158 | ZEOLLA PHYSICAL THERAPY INC |
| Organization Legal Name | ZEOLLA PHYSICAL THERAPY INC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michele A Zeolla | Physical Therapy | Zeolla Physical Therapy Inc | 5927 Kanan Rd, Agoura Hills, CA 91301-1688 |
| Street Address |
5927 KANAN RD |
| City | AGOURA HILLS |
| State | CA |
| Zip | 91301-1688 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michele A Zeolla | Physical Therapy | Zeolla Physical Therapy Inc | 5927 Kanan Rd, Agoura Hills, CA 91301-1688 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dennis Jorge | Optometry | 5849 Kanan Rd, Agoura Hills, CA 91301-1651 | |
| Vahagn J Keshishyan | Chiropractic | Keshishian Chiropractic Inc. | 5887 Kanan Rd, Agoura, CA 91301-1651 |
| Melina Keshishian | Chiropractic | Keshishian Chiropractic Inc. | 5887 Kanan Rd, Agoura, CA 91301-1651 |
| George W Harris | Chiropractic | 5887 Kanan Rd, Agoura, CA 91301-1651 | |
| Christopher C Hair | Optometry | Christopher C Hair Optometric | 5849 Kanan Rd, Agoura Hills, CA 91301-1651 |
| Lisa E Harris | Psychologist, Clinical | 5923 Kanan Rd, Agoura Hills, CA 91301-1688 | |
| Gary David Newquist | Clinical Psychologist | 5923 Kanan Rd, Agoura Hills, CA 91301-1688 | |
| Ajay K Malhotra | Psychologist, Clinical | 5014 Chesebro Rd 2nd Floor, Agoura Hills, CA 91301-2210 | |
| Cordelia Rose E Onyekwe | Nurse Practitioner | Asana Integrated Medical Group | 5016 Chesebro Rd, Suite 200, Agoura Hills, CA 91301-2277 |
| Nitin Nanda | Geriatric Psychiatry | 5016 Chesebro Rd, Suite 200, Agoura Hills, CA 91301-2277 | |
| Find all physicians in zip 91301 | |||
| City | AGOURA HILLS |
| Zip Code | 91301 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | AGOURA HILLS + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Mark Tiedeman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.