Individual provider Active NPI

David Michael Tellalian, MD

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1003073826
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A110417 Issued in CA
Practice address
8635 W 3Rd St Ste 465W
Los Angeles, CA 90048-6111
Phone
(310) 358-2300
Fax
(310) 358-2308
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X A110417 CA
Internal Medicine Physician 207R00000X A110417 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 465W
Los Angeles, CA 90048-6111

Mailing address

8390 Champions Gate Blvd
Suite 215
Champions Gate, FL 33896-8310
Phone (407) 390-1677

Other practice location 1

1400 S Grand Ave
#801
Los Angeles, CA 90015-3048
Phone (213) 741-9727

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120413000471 CA Practitioner - Infectious DiseasePractitioner - Internal Medicine 4789845025 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

4725 -4733 Sunset Blvd
Los Angeles, CA 90027-6021
Phone (323) 783-4011

4733 W Sunset Blvd
Los Angeles, CA 90027-6021
Phone (213) 667-4784

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A110417CAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Jan 14, 2012 Accepting new patients
Men'S Health Foundation Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 14, 2024 Accepting new patients
County of Los Angeles CurrentSince Jan 14, 2012 Accepting new patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 3, 2017 Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 14, 2024 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

8635 W 3rd St
Ste 1180W
Los Angeles, CA 90048
Phone (310) 358-2300

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

9201 W Sunset Blvd
Ste 812
West Hollywood, CA 90069
Phone (310) 271-4656

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: davidtellalian@scmmg.allscriptsdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1003073826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD",
            "address_2": "SUITE 215",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "338968310",
            "telephone_number": "407-390-1677",
            "fax_number": "407-390-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 465W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486111",
            "telephone_number": "310-358-2300",
            "fax_number": "310-358-2308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 S Grand Ave",
            "address_2": "#801",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153048",
            "country_code": "US",
            "telephone_number": "213-741-9727",
            "fax_number": "213-741-0867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLALIAN",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2024-12-30",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A110417",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A110417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.