NPIMap

Organization Active NPI

Talbert Medical Group, P.C.

  • Internal Medicine Physician
  • Tustin, CA
National Provider Identifier
1518968098
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TALBERT MEDICAL GROUP, P.C.
Doing business as
Talbert Medical Group
Practice address
13152 Newport Ave
Tustin, CA 92780-3416
Phone
(714) 443-4864
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Authorized official

Name
John G. Liethen
Title
Secretary
Phone
(952) 205-6262

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X CA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X CA Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X CA

Addresses

Primary practice location

13152 Newport Ave
Tustin, CA 92780-3416

Mailing address

P.O. Box 6400
Torrance, CA 90504-6400
Phone (714) 443-4864

Other identifiers 1

IdentifierTypeStateIssuer
GR007786BMedicaidCA

Other names 1

  • Talbert Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

13152 Newport Ave
Tustin, CA 92780
Phone (714) 442-4864

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1518968098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6400",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905046400",
            "telephone_number": "714-443-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13152 NEWPORT AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803416",
            "telephone_number": "714-443-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALBERT MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2019-08-20",
        "status": "A",
        "authorized_official_last_name": "LIETHEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "952-205-6262"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR007786B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Talbert Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Talbert Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.