# JOHN TALIEH MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356694020
- **Authorized official:** DR. YAHYA JOHN TALIEH MD (SURGEON)
- **Authorized official phone:** (209) 522-0600

## Contact information

- **Practice address:** 1401 SPANOS CT STE 203, MODESTO, CA 95355-2813
- **Practice address phone:** (209) 522-0600
- **Practice address fax:** (209) 491-0116
- **Mailing address:** PO BOX 577134, MODESTO, CA 95357-7134
- **Mailing address phone:** (209) 522-0600
- **Mailing address fax:** (209) 491-0116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A73331 | CA | Yes |

## Other

- **Enumeration date:** 10/18/2012
- **Last updated:** 10/18/2012