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General NPI Number Information
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NPI Number | 1861976235
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Entity Type | Organization
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Legal Business Name | TELEDOCS, INC
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 8350 SANTA MONICA BLVD APT 312
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4488
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Country | US
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Telephone | 747-322-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 1521 ALTON RD STE 463
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3301
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Country | US
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Telephone | 747-322-0060
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRISTAN SCHUKRAFT
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Credential |
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Telephone | 818-231-0751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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