Healthcare Provider Details

I. General information

NPI: 1093275331
Provider Name (Legal Business Name): TAL DO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 W LA PALMA AVE STE 404
ANAHEIM CA
92801-2806
US

IV. Provider business mailing address

2040 S SANTA CRUZ ST STE 215
ANAHEIM CA
92805-6821
US

V. Phone/Fax

Practice location:
  • Phone: 714-772-8282
  • Fax:
Mailing address:
  • Phone: 714-577-2124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-47192
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberU3198
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA193370
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number333877
License Number StateLA
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA193370
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04-47192
License Number StateKS
# 8
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberU3198
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: