MEDICARE: DR. TALENE MARY CHURUKIAN DO

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
1	207R00000X	Internal Medicine Physician	2OA9346	CA
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	20A9346	CA

General Provider Information

NPI Number	:	1538356902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TALENE MARY CHURUKIAN DO

Provider Business Mailing Address
First Line	:	41990 COOK ST STE 102
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6101
Country	:	US
Telephone Number	:	760-773-1411
Fax Number	:	760-773-4398

Provider Business Practice Location Address
First Line	:	41990 COOK ST STE 102
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-6101
Country	:	US
Telephone Number	:	760-773-1411
Fax Number	:	760-773-4398

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	05/24/2021

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