Individual
KEITH ALLEN TELLIGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5966 COSTELLO AVE, VALLEY GLEN, CA 91401-4338
(818) 667-4365
Mailing address
5966 COSTELLO AVE, VALLEY GLEN, CA 91401-4338
(818) 667-4365
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
9176
CA
373H00000X
Day Training/Habilitation Specialist
Primary
9176
CA
Other
Enumeration date
11/15/2012
Last updated
05/08/2025
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