Bruke Tedla
Internal Medicine, Adult Congenital Heart Disease in Loma Linda, CA. Individual provider (NPI-1).
NPI number1982102539
StatusActive
Last updated in NPPESNov 11, 2025
Details
- NPI
- 1982102539
- Entity type
- Individual (NPI-1)
- Name
- Bruke Tedla
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 29, 2018
- Certification date
- Nov 11, 2025
- Last updated
- Nov 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CARDIOVASCULAR DISEASE (CARDIOLOGY)
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RA0002X | Internal Medicine, Adult Congenital Heart Disease | A160609 | CA | Yes |
Practice location
11324 Anderson StLoma Linda, CA 92350-1728
Phone 909-558-8590
Mailing address
2068 Orange Tree Ln Ste 215Redlands, CA 92374-4555
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