Provider Demographics
NPI:1053615740
Name:JOHN R. TESMAN, M.D., INC.
Entity type:Organization
Organization Name:JOHN R. TESMAN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEMMLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-258-6200
Mailing Address - Street 1:9600 CUYAMACA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-2692
Mailing Address - Country:US
Mailing Address - Phone:619-258-6200
Mailing Address - Fax:
Practice Address - Street 1:2705 LOMA VISTA RD STE 205
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1582
Practice Address - Country:US
Practice Address - Phone:805-652-5011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65726207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty