Healthcare Provider Details

I. General information

NPI: 1902498439
Provider Name (Legal Business Name): TELEMEDORA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 01/11/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 BORREGAS AVE
SUNNYVALE CA
94089-1309
US

IV. Provider business mailing address

1250 BORREGAS AVE # 62
SUNNYVALE CA
94089-1309
US

V. Phone/Fax

Practice location:
  • Phone: 650-687-7368
  • Fax:
Mailing address:
  • Phone: 650-687-7368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SUBAILA ZIA
Title or Position: CEO
Credential: MD, MBA, FCCP
Phone: 650-687-7368