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NPI Code Detail

MEDICARE: CALIFORNIA TELEHEALTH ASSOCIATES, PC

MEDICARE: CALIFORNIA TELEHEALTH ASSOCIATES, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number : 1891451886
Entity Type Code : Organization
Provider Name (Legal Business Name) : CALIFORNIA TELEHEALTH ASSOCIATES, PC
Provider Business Mailing Address
First Line : 355 LEXINGTON AVE FL 12
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6612
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1145 FELSPAR ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-2925
Country : US
Telephone Number : 858-246-2161
Fax Number :
Authorized Official
Title or Position : CEO
Name : SCHAFER BOEDER
Credential : MD
Telephone Number : 858-246-2161
Provider Enumeration Date : 11/13/2021
Last Update Date : 11/13/2021

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