Basic Information
| Provider Information | |||||||||
| NPI: | 1902498439 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TELEMEDORA, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1250 BORREGAS AVE # 62 | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940891309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506877368 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1250 BORREGAS AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940891309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506877368 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2021 | ||||||||
| LastUpdateDate: | 02/05/2021 | ||||||||
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| AuthorizedOfficialLastName: | ZIA | ||||||||
| AuthorizedOfficialFirstName: | SUBAILA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6506877368 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD, MBA, FCCP | ||||||||
| NPICertificationDate: | 02/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RS0012X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.