Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 0434465 | KS |
Y | 207RR0500X | Rheumatology | 160745 | CA |
N | 207RR0500X | Rheumatology | 2012022046 | MO |
NPI | 1104951235 |
---|---|
Provider Name | Connie Teng |
First Address | Torrance, CA 90505-6514 |
Second Address | Redondo Beach, CA 90277-3041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 18/11/2021 |