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NPI Code Detail

MEDICARE: DAVID MICHAEL TELLALIAN MD

MEDICARE: DAVID MICHAEL TELLALIAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RI0200XInfectious Disease PhysicianA110417CA
2207R00000XInternal Medicine PhysicianA110417CA

General Provider Information

NPI Number : 1003073826
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MICHAEL TELLALIAN MD
Provider Business Mailing Address
First Line : 8390 CHAMPIONS GATE BLVD
Second Line : SUITE 215
City : CHAMPIONS GATE
State : FL
Zip : 33896-8310
Country : US
Telephone Number : 407-390-1677
Fax Number : 407-390-1765
Provider Business Practice Location Address
First Line : 8635 W 3RD ST STE 465W
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-6111
Country : US
Telephone Number : 310-358-2300
Fax Number : 310-358-2308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 12/30/2024

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Directions to “ DAVID MICHAEL TELLALIAN MD” Practice Location

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