Test San Diego

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TEST SAN DIEGO

Practice address

4080 Centre St Ste 107
San Diego, CA 92103-2655

Phone

(888) 738-8772

NPI assigned

Aug 24, 2022

Last updated

Aug 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Roger Stellers

Title

Authorized Official

Phone

(619) 494-0397

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1912626862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4080 CENTRE ST STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 CENTRE ST STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032655",
            "telephone_number": "888-738-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEST SAN DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "STELLERS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "619-494-0397"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Miller DDS, Inc (Bay Park Dental Group)
• Adla Tessier, M.D.
• Jeanette Marie Tessier, PHARM D
• Felicia Nicole Tessman
• Debbra Anne Tessmer-Wagner, M.A., L.M.F.T.
• Arianne Testa
• Brent H Testerman
• Elise M. Tetelman, PA-C, MBA
• Paige Tetreau
• Russell Tett, PHARMD

• Clinical Medical Laboratory in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.