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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
1207R00000XInternal Medicine PhysicianCA
2207V00000XObstetrics & Gynecology PhysicianCA
3208000000XPediatrics PhysicianCA
42080P0006XDevelopmental - Behavioral Pediatrics PhysicianCA
52085R0202XDiagnostic Radiology PhysicianCA
6207Q00000XFamily 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 : 1326049800
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 : 818 W ALONDRA BLVD
Second Line :
City : COMPTON
State : CA
Zip : 90220-3500
Country : US
Telephone Number : 310-537-1337
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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