Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1740618115 Deactivated / Inactive NPI Male Practitioner

Dr. George Tiedeman , MD

General Practice • La Jolla, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. George Tiedeman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 23, 2013
NPI Deactivation Date September 18, 2025
Total Practice Duration ~12 Years of Practice (2013 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. George Tiedeman, MD was a registered General Practice practicing in La Jolla, CA. Throughout an active medical career spanning 12 years, Dr. Tiedeman provided care at the practice location at 849 COAST BLVD until profile deactivation on 2025-09-18.

Practice Location & Contact Primary Location

Practice Address

849 Coast Blvd
# Cm 212

La Jolla, CA 920374223

Telephone 8584564183
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in La Jolla, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
25 Specialists

Practicing in La Jolla, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License CA A25115

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Caitlin Woodruff , MOT

Occupational Therapist

NPI 1235074212

Master of Occupational Therapy

Lauren Coughran , OT

Occupational Therapist - Pediatrics

NPI 1447517370

Occupational Therapist

Jessica Jones , MS, CCC-SLP

Speech-Language Pathologist

NPI 1497357453

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

Caitlin Bier , OTR, L

Occupational Therapist

NPI 1700517620

Occupational Therapist Registered, L

Carol Foreman , MA

Hearing Instrument Specialist

NPI 1790998342

Master of Arts

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 18, 2025

Record deactivated on September 18, 2025

NPI Profile Active October 23, 2013

NPI status registered as active in NPPES database

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Updated Practice Location October 23, 2013

Registered at 849 COAST BLVD, # CM 212, LA JOLLA, CA 920374223 (Tel: 8584564183)

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Updated Business Mailing Address October 23, 2013

Registered at 849 COAST BLVD, # CM 212, LA JOLLA, CA 920374223 (Tel: 8584564183)

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Provider Name / Credentials Updated October 23, 2013

Recorded as GEORGE TIEDEMAN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 23, 2013

General Practice (License #A25115 in CA)

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Initial NPI Registration & Enumeration October 23, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740618115
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 23, 2013
Last Update: October 23, 2013
Deactivation Date: September 18, 2025

Mailing Address

849 Coast Blvd, # Cm 212

La Jolla, CA 920374223

Phone: 8584564183

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.