Provider Demographics
NPI:1003102567
Name:BARTLOTTI TELESZ, JENNIFER N (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:N
Last Name:BARTLOTTI TELESZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33444 PAUBA RD
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-9209
Mailing Address - Country:US
Mailing Address - Phone:951-595-7388
Mailing Address - Fax:682-365-4718
Practice Address - Street 1:33444 PAUBA RD
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-9209
Practice Address - Country:US
Practice Address - Phone:951-595-7388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN55214207L00000X
CAA136630207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN050002650Medicare PIN