Provider Demographics
NPI:1730143116
Name:HECKMAN, TED ALAN (MD)
Entity type:Individual
Prefix:
First Name:TED
Middle Name:ALAN
Last Name:HECKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 RIVERVIEW DR
Mailing Address - Street 2:N/A
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-9425
Mailing Address - Country:US
Mailing Address - Phone:530-589-0993
Mailing Address - Fax:530-589-1883
Practice Address - Street 1:5629 CANYON VIEW DRIVE
Practice Address - Street 2:STE B
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969
Practice Address - Country:US
Practice Address - Phone:530-876-3141
Practice Address - Fax:530-876-3149
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG36530207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG36530OtherSTATE LICENSE
CAGR0014101Medicaid
CAGR0014101Medicaid
CAGR0014101Medicaid
ZZZ75470ZMedicare ID - Type Unspecified