| Andrea Tieng, Md Inc | |
|
10801 Foothill Blvd Ste 106 Rancho Cucamonga CA 91730-7695 | |
| (909) 255-7200 | |
| (909) 255-7215 |
| Full Name | Andrea Tieng, Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10801 Foothill Blvd Ste 106, Rancho Cucamonga, California |
| Authorized Official Name and Position | Andrea S. Tieng (MD) |
| Authorized Official Contact | 9092557200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Tieng, Md Inc 10801 Foothill Blvd Ste 106 Rancho Cucamonga CA 91730-7695 Ph: (909) 255-7200 | Andrea Tieng, Md Inc 10801 Foothill Blvd Ste 106 Rancho Cucamonga CA 91730-7695 Ph: (909) 255-7200 |
| NPI Number | 1013276575 |
|---|---|
| Provider Enumeration Date | 05/03/2012 |
| Last Update Date | 01/25/2022 |
| Medicare PECOS PAC ID | 6901058528 |
|---|---|
| Medicare Enrollment ID | O20121206000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013276575 | NPI | - | NPPES |
| 1356528566 | Other | PERSONAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | A106477 (California) | Primary |
| Provider Name | Andrea S Tieng |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356528566 PECOS PAC ID: 9133256860 Enrollment ID: I20100428000624 |
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