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Organization
TALBERT MEDICAL GROUP, P.C.
Active
Organization
TALBERT MEDICAL GROUP, P.C.
Active
Other names
Talbert Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G. LIETHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
9930 TALBERT AVE, FOUNTAIN VALLEY, CA 92708-5153
(714) 964-6229
(714) 378-6233
Mailing address
PO BOX 6400, TORRANCE, CA 90504-6400
(310) 783-5552
(310) 783-5581
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
CA
152W00000X
Optometrist
—
CA
183500000X
Pharmacist
—
AR
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
CA
207Q00000X
Family Medicine Physician
—
CA
207R00000X
Internal Medicine Physician
Primary
—
CA
207V00000X
Obstetrics & Gynecology Physician
—
CA
207W00000X
Ophthalmology Physician
—
CA
207X00000X
Orthopaedic Surgery Physician
—
CA
207Y00000X
Otolaryngology Physician
—
CA
208000000X
Pediatrics Physician
—
CA
2085R0202X
Diagnostic Radiology Physician
—
CA
208600000X
Surgery Physician
—
CA
208800000X
Urology Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0077860
—
CA
Enumeration date
08/04/2005
Last updated
08/19/2019
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