Healthcare Provider Details

I. General information

NPI: 1417664657
Provider Name (Legal Business Name): MDTEL HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 CAMINO DEL RIO S STE 118
SAN DIEGO CA
92108-3546
US

IV. Provider business mailing address

438 CAMINO DEL RIO S STE 118
SAN DIEGO CA
92108-3546
US

V. Phone/Fax

Practice location:
  • Phone: 619-837-2505
  • Fax:
Mailing address:
  • Phone: 619-837-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name: JEREMIE MEYERS
Title or Position: CEO
Credential:
Phone: 619-310-3633