Individual
JANOS TALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
34800 BOB WILSON DR, NMCSD, DEPARTTMENT OF SURGERY, SAN DIEGO, CA 92134-1098
(619) 532-7577
Mailing address
6365 LAKE KATHLEEN AVE, SAN DIEGO, CA 92119-3130
(619) 741-3297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A62642
CA
Other
Enumeration date
12/12/2006
Last updated
11/17/2021
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