Tetzlaff, Jason Thomas William

Tetzlaff, Jason Thomas William is an individual health care provider with primary practice located at 3402 Tarawa Rd Sbt-12, San Diego CA 92155-5176. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Independent Duty Corpsman, Other Service Providers / Specialist, Other Service Providers / Military Health Care Provider. Other Service Providers / Independent Duty Corpsman is his primary health care specialty. Tetzlaff, Jason Thomas William can be contacted via phone (619) 437-5539.

Contact Information

Primary practice address
3402 Tarawa Rd Sbt-12 San Diego CA 92155-5176
Phone: (619) 437-5539
Fax: (619) 437-2955
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X 2099 Arizona
Other Service Providers / Specialist 174400000X California
Other Service Providers / Military Health Care Provider 171000000X 2099 California

Profile Details

NPI number 1043247091
LBN Legal business name Tetzlaff, Jason Thomas William
Credentials IDC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Apr 22nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043247091 NPPES
Arizona Other 2099 US NAVY

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