Organization
TALYA MD CORP
Active
Other names
NORCAL PEDIATRIC GI
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA M SMITH (BILLING MANAGER)
(707) 628-8799
Entity
Organization
Contact information
Practice address
8303 MOSS CT, GRANITE BAY, CA 95746-7320
(916) 899-1123
Mailing address
9288 MADISON AVE, ORANGEVALE, CA 95662-5857
(916) 899-1123
(916) 510-2293
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A123964
LICENSE
CA
Enumeration date
05/24/2022
Last updated
03/15/2023
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