Doctor Name: | DR. JEAN L TALLEYRAND |
NPI Number: | 1689963456 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A61572 |
Business Practice Address: | 1426 Fillmore St Suite 206 San Francisco, CA - 941155236 |
Business Phone Number: | 4157225195 |
Business Fax Number: | 4157043324 |
Mailing Address: | Po Box 174, YORKVILLE |
State: | CA |
Postal Code: | 954940174 |
Phone Number: | 4157225195 |
Fax Number: | 4157043324 |
NPI Enumeration Date: | 04/01/2011 |
NPI Last Update Date: | 04/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A61572 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |