Organization
DAVID TELLALIAN M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TELLALIAN MD (PRESIDENT)
(714) 664-0045
Entity
Organization
Contact information
Practice address
720 N TUSTIN AVE, 201, SANTA ANA, CA 92705-3606
(714) 664-0045
(714) 664-0049
Mailing address
720 N TUSTIN AVE, 201, SANTA ANA, CA 92705-3606
(714) 664-0045
(714) 664-0049
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A110417
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A110417
MED LICENSE
CA
Enumeration date
09/24/2014
Last updated
09/24/2014
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