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NPI Code Detail

MEDICARE: TALBERT MEDICAL GROUP, P.C.

MEDICARE: TALBERT MEDICAL GROUP, P.C.
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
1133V00000XRegistered DietitianCA
2152W00000XOptometristCA
3174400000XSpecialistCA
4207V00000XObstetrics & Gynecology PhysicianCA
5208000000XPediatrics PhysicianCA
62085R0202XDiagnostic Radiology PhysicianCA
7213E00000XPodiatristCA
8207R00000XInternal Medicine PhysicianCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225039704
Entity Type Code : Organization
Provider Name (Legal Business Name) : TALBERT MEDICAL GROUP, P.C.
Provider Business Mailing Address
First Line : P.O. BOX 6400
Second Line :
City : TORRANCE
State : CA
Zip : 90504-6400
Country : US
Telephone Number : 310-783-5552
Fax Number : 310-783-5581
Provider Business Practice Location Address
First Line : 8311 FLORENCE AVE
Second Line :
City : DOWNEY
State : CA
Zip : 90240-3928
Country : US
Telephone Number : 562-923-4911
Fax Number :
Authorized Official
Title or Position : SECRETARY
Name : JOHN G. LIETHEN
Credential :
Telephone Number : 952-205-6262
Provider Enumeration Date : 08/09/2005
Last Update Date : 08/19/2019

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Directions to “TALBERT MEDICAL GROUP, P.C. ” Practice Location

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