Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark Andrew Tiedeman, PHYSICALTHERAPIST

Individual provider Physical Therapist · NPI 1730478066

Mr. Mark Andrew Tiedeman, PHYSICALTHERAPIST is a Physical Therapist in Private Practice in Agoura Hills, California. Qualified in 2001, 25 years ago. Practices with Zeolla Physical Therapy Inc, a 5-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
25
Licensed in
CA
In the registry since
2011
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

5927 Kanan Rd
Agoura Hills, CA 91301-1688
Phone: (818) 889-0158
Fax: (818) 889-4708
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT27038 (CA)

Record details

NPI number1730478066
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICALTHERAPIST
Sole proprietorYes
NPI enumeratedApril 7, 2011
Last updated in NPPESApril 7, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Zeolla Physical Therapy Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Agoura Hills