Tetzlaff, Joel
Tetzlaff, Joel is an individual health care provider with primary practice located at 2720 N Harbor Blvd Suite 130, Fullerton CA 92835-2609. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tetzlaff, Joel can be contacted via phone (714) 449-6230.Contact Information
Primary practice address
2720 N Harbor Blvd Suite 130
Fullerton CA 92835-2609
Phone: (714) 449-6230
Fax: (714) 449-1773
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA18035 | California |
Profile Details
| NPI number | 1164621074 |
|---|---|
| LBN Legal business name | Tetzlaff, Joel |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2007 |
| Last updated | Jul 12th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164621074 | NPPES |
| California | Other | PA18035 | LICENSE |
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