DR. EDWARDO TELLEZ M.D. NPI 1104833516

NPI Information

NPI: 1104833516
Provider Name: DR. EDWARDO TELLEZ, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
16510 BLOOMFIELD AVE
CERRITOS, CA
ZIP 90703
Phone: (562) 229-0902
Get Directions

DR. Edwardo Tellez, M.D. is a pediatrics in Cerritos, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Edwardo Tellez, M.D. NPI is 1104833516. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

16510 BLOOMFIELD AVE
CERRITOS, CA
ZIP 90703-346
Phone: (562) 229-0902
Fax: (562) 229-0952

The NPI 1104833516 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/1/2006 and was last updated on 7/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		G63350	CALIFORNIA	No
2	208000000X	Pediatrics		63350	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00G633500	MEDICAID	CALIFORNIA
2	WG63350C	MEDICARE PIN	CALIFORNIA
3	370020277	OTHER	CALIFORNIA	RAILROAD MEDICARE
4	370020277	OTHER	CALIFORNIA	MEDICARE RAILROAD
5	00G63350C	MEDICAID	CALIFORNIA
6	E95713	MEDICARE UPIN	CALIFORNIA
7	00G63350	OTHER	CALIFORNIA	BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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