Talbert Medical Group, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TALBERT MEDICAL GROUP, P.C.

Doing business as

Talbert Medical Group

Practice address

3650 South St
Ste 303
Lakewood, CA 90712-1502

Phone

(562) 633-9734

Fax

(562) 633-9753

NPI assigned

Oct 2, 2006

Organization subpart

No

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 2

Addresses

Other identifiers 1

Other names 1

• Talbert Medical Group Doing business as

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566259200000",
    "number": "1720171325",
    "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": "310-783-5552",
            "fax_number": "310-783-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST",
            "address_2": "STE 303",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121502",
            "telephone_number": "562-633-9734",
            "fax_number": "562-633-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALBERT MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "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": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUSINESS LICENSE",
            "identifier": "4143",
            "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"
        }
    ]
}

• Tagaloa-Tulifau Foot and Ankle Center, Inc.
• Mafutaga S. Tagaloa-Tulifau, D.P.M.
• Kara Megumi Takeda, O.D.
• Karmbir Takhar, FNP
• Alyssa Nicole Talavera
• Anne Tallent
• Anna Talonova
• James Kim Tan, D.D.S.
• Kevin Tan
• Layheang Tang, PHARMD

• Family Medicine Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Family Medicine Physician in California

• 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.