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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