Hagos Kiflay Teklay

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

PHN559278 Issued in CA

Practice address

6991 Balboa Ave RM 70
San Diego, CA 92111-3447

Phone

(858) 496-8232

Fax

(858) 496-8234

NPI assigned

Jun 3, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1497379663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6991 BALBOA AVE RM 70",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113447",
            "telephone_number": "858-496-8232",
            "fax_number": "858-496-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6991 BALBOA AVE RM 70",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113447",
            "telephone_number": "858-496-8232",
            "fax_number": "858-496-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLAY",
        "first_name": "HAGOS",
        "middle_name": "KIFLAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "RN95152885",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "PHN559278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE STATE OF CALIFORNIA",
            "identifier": "PHN559278",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Tejeda
• Vanessa Eugenia Tejera
• Betlhem Teka, PHARMD
• Larissa Tatiana Tekerian
• Sera Tekin
• Hagos Damer Teklom
• Yodit Mekonnen Teklu, PHARM.D.
• Diana Lee Telahun, PHARMD
• Enko Telahun, PHARM.D.
• Telecare

• Community Health Registered Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Community Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.