Organization
ALL SOUTH BAY FOOTCARE PODIATRY GROUP, INC.
Active
Organization
ALL SOUTH BAY FOOTCARE PODIATRY GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY JAY TELES D.P.M. (PRESIDENT AND OWNER)
(310) 326-0202
Entity
Organization
Contact information
Practice address
23365 HAWTHORNE BLVD STE 101, TORRANCE, CA 90505-3720
(310) 326-0202
(310) 326-5826
Mailing address
23365 HAWTHORNE BLVD STE 101, TORRANCE, CA 90505-3720
(310) 326-0202
(310) 326-5826
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E2898
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E28980
—
CA
Enumeration date
02/01/2007
Last updated
09/24/2013
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