Provider Demographics
NPI:1417377607
Name:TALAVERA, KARLA (MD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:TALAVERA
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 1:1760 CHICAGO AVE STE J3
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-2358
Mailing Address - Country:US
Mailing Address - Phone:951-781-2200
Mailing Address - Fax:
Practice Address - Street 1:9825 MAGNOLIA AVE STE B349
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3562
Practice Address - Country:US
Practice Address - Phone:951-444-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-26
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61176251207R00000X, 208M00000X
CAA143128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine