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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 BG. LIETHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
19066 MAGNOLIA ST, HUNTINGTON BEACH, CA 92646-2232
(714) 968-0068
(714) 378-2188
Mailing address
P.O. BOX 6400, TORRANCE, CA 90504-6400
(310) 783-5552
(310) 783-5581
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
CA
174400000X
Specialist
—
CA
207K00000X
Allergy & Immunology Physician
—
CA
207N00000X
Dermatology Physician
—
CA
207Q00000X
Family Medicine Physician
—
CA
207R00000X
Internal Medicine Physician
Primary
—
CA
207T00000X
Neurological Surgery Physician
—
CA
207V00000X
Obstetrics & Gynecology Physician
—
CA
208000000X
Pediatrics Physician
—
CA
2085R0202X
Diagnostic Radiology Physician
—
CA
213E00000X
Podiatrist
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0077862
—
CA
Enumeration date
08/04/2005
Last updated
08/19/2019
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