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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
644 E REGENT ST, STE. 100, INGLEWOOD, CA 90301-1433
(310) 674-3807
(310) 674-3810
Mailing address
P.O. BOX 6400, TORRANCE, CA 90504-6400
(310) 674-3807
(310) 674-3810
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033021
BUSINESS LICENSE
CA
Enumeration date
03/27/2007
Last updated
08/19/2019
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