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NPI Code Detail

MEDICARE: TREO MEDICAL GROUP

MEDICARE: TREO MEDICAL GROUP
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
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1740040351
Entity Type Code : Organization
Provider Name (Legal Business Name) : TREO MEDICAL GROUP
Provider Business Mailing Address
First Line : 10736 JEFFERSON BLVD # 614
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4933
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1849 SAWTELLE BLVD STE 610
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-7013
Country : US
Telephone Number : 424-210-7724
Fax Number : 800-493-9423
Authorized Official
Title or Position : OWNER/ CEO
Name : JANELLE HAIDER
Credential : MD
Telephone Number : 310-751-0180
Provider Enumeration Date : 03/20/2024
Last Update Date : 03/20/2024

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Directions to “TREO MEDICAL GROUP ” Practice Location

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