Edwardo Tellez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

63350 Issued in CA

Practice address

16510 Bloomfield Ave
Cerritos, CA 90703-9346

Phone

(562) 229-0902

Fax

(562) 229-0952

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pioneer Medical Group Inc.

  • Multi-Specialty Clinic/Center
  • Bellflower, CA
  • NPI 1548303589
  Medicare reassignment NPD
• Bright Medical Associates, Inc.

  • Specialist
  • Whittier, CA
  • NPI 1578576880
  NPD (past)
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• Los Alamitos Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Los Alamitos, CA
  • NPI 1497780084
  NPD (past)
• Pih Health Downey Hospital

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1265433551
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1104833516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DRIVE DEPT 6008",
            "city": "CHICAGO",
            "state": "CA",
            "postal_code": "606756008",
            "telephone_number": "562-282-1419",
            "fax_number": "562-920-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16510 BLOOMFIELD AVE",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039346",
            "telephone_number": "562-229-0902",
            "fax_number": "562-229-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEZ",
        "first_name": "EDWARDO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G63350",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "63350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G63350",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G63350C",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "370020277",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "370020277",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G633500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Taylor
• Patricia M Taylor, PSYCHOLOGIST
• Taylored Care Services LLC
• Teach Me 2 Play
• Gabriela Tecun Funes
• Almarely Tepox
• Joseph Paul Terrebrood
• Terri Houston
• Shadai Terry
• Kiyo Teshima, RN

• Pediatrics Physician in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.