Provider Demographics
NPI:1568115681
Name:TELECLINIC LLC
Entity Type:Organization
Organization Name:TELECLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:YAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEERZADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-674-2472
Mailing Address - Street 1:11417 W BERNARDO CT STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1639
Mailing Address - Country:US
Mailing Address - Phone:619-674-2472
Mailing Address - Fax:
Practice Address - Street 1:11417 W BERNARDO CT STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1639
Practice Address - Country:US
Practice Address - Phone:619-674-2472
Practice Address - Fax:855-293-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)