Healthcare Provider Details

I. General information

NPI: 1265509129
Provider Name (Legal Business Name): IRA H. TILLES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 E ROMIE LN
SALINAS CA
93901-4029
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-757-4333
  • Fax:
Mailing address:
  • Phone: --
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberG81641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: