| Doctor Name: | JUTARA SRIVALI TEAL |
| NPI Number: | 1962719146 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.AC |
| License Number: | AC13184 |
| Business Practice Address: | 3815 Atlantic Ave #5 Long Beach, CA - 908073500 |
| Business Phone Number: | 5628963685 |
| Business Fax Number: | |
| Mailing Address: | 2933 Cedar Ave, LONG BEACH |
| State: | CA |
| Postal Code: | 908061414 |
| Phone Number: | 5628963685 |
| Fax Number: | 5625955682 |
| NPI Enumeration Date: | 09/09/2010 |
| NPI Last Update Date: | 09/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | AC13184 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |