Active NPI
Julian Tellez, PA-C
- Medical Physician Assistant
- Duarte, CA
National Provider Identifier
1700056637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 19320
- Practice address
- 931 Buena Vista St
Suite 205
Duarte, CA 91010-1712 - Phone
- (626) 358-1897
- Fax
- (626) 301-0937
- NPI assigned
- Mar 6, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 19320 | CA | Primary |
Addresses
Primary practice location
931 Buena Vista St
Suite 205
Duarte, CA 91010-1712
Mailing address
931 Buena Vista St Ste 205
Suite 205
Duarte, CA 91010-1713
Phone (626) 358-1897
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 19320 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292889600000",
"number": "1700056637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 BUENA VISTA ST STE 205",
"address_2": "SUITE 205",
"city": "DUARTE",
"state": "CA",
"postal_code": "910101713",
"telephone_number": "626-358-1897",
"fax_number": "626-301-0937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "931 BUENA VISTA ST",
"address_2": "SUITE 205",
"city": "DUARTE",
"state": "CA",
"postal_code": "910101712",
"telephone_number": "626-358-1897",
"fax_number": "626-301-0937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLEZ",
"first_name": "JULIAN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-06",
"last_updated": "2010-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA 19320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duarte, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.