Dr Edwardo Tellez, MD | |
16510 Bloomfield Ave, Cerritos, CA 90703-9346 | |
(562) 229-0902 | |
(562) 229-0952 |
Full Name | Dr Edwardo Tellez |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 16510 Bloomfield Ave, Cerritos, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104833516 | NPI | - | NPPES |
00G63350 | Other | CA | BLUE SHIELD |
00G63350C | Medicaid | CA | |
370020277 | Other | CA | MEDICARE RAILROAD |
370020277 | Other | CA | RAILROAD MEDICARE |
00G633500 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | G63350 (California) | Secondary |
208000000X | Pediatrics | 63350 (California) | Primary |
Entity Name | Pioneer Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548303589 PECOS PAC ID: 1759317696 Enrollment ID: O20050712001246 |
Mailing Address | Practice Location Address |
---|---|
Dr Edwardo Tellez, MD 75 Remittance Drive Dept 6008, Chicago, CA 60675-6008 Ph: (562) 282-1419 | Dr Edwardo Tellez, MD 16510 Bloomfield Ave, Cerritos, CA 90703-9346 Ph: (562) 229-0902 |
Sowmya Ananthanarayanan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 13031 Sutton St, Cerritos, CA 90703 Phone: 949-892-5357 | |
Cecilia Santiago Carigma, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 18821 Pioneer Blvd, Suite D, Cerritos, CA 90701 Phone: 562-403-0400 |