Richard W Tezak, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

G42005 Issued in CA

Practice address

1441 Constitution Blvd
BLDG. 200, Floor One, Suite 103
Salinas, CA 93906-3100

Phone

(831) 755-4123

Fax

(831) 755-4123

NPI assigned

Jul 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1619998960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 BUNKER HILL WAY",
            "address_2": "SUITE 100",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939066013",
            "telephone_number": "831-769-1304",
            "fax_number": "831-757-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 CONSTITUTION BLVD",
            "address_2": "BLDG. 200, FLOOR ONE, SUITE 103",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939063100",
            "telephone_number": "831-755-4123",
            "fax_number": "831-755-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEZAK",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "G42005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70127F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Public Health & General Preventive Medicine Physician in Salinas, CA
• Providers in Salinas, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; 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.