Provider Demographics
NPI:1598894792
Name:TALHA MEMON M.D. INC.
Entity Type:Organization
Organization Name:TALHA MEMON M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-293-2748
Mailing Address - Street 1:39755 DATE ST
Mailing Address - Street 2:#101
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2007
Mailing Address - Country:US
Mailing Address - Phone:951-698-6629
Mailing Address - Fax:951-698-8732
Practice Address - Street 1:39755 DATE ST
Practice Address - Street 2:#101
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2007
Practice Address - Country:US
Practice Address - Phone:951-698-6629
Practice Address - Fax:951-698-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41831207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0082740Medicaid
CAGR0082740Medicaid
CAA29473Medicare UPIN