Provider Demographics
NPI:1265975288
Name:RAMAN K TALWAR MD INC
Entity type:Organization
Organization Name:RAMAN K TALWAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:PATTYE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-879-1935
Mailing Address - Street 1:PO BOX 900568
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93590-0568
Mailing Address - Country:US
Mailing Address - Phone:661-789-7693
Mailing Address - Fax:
Practice Address - Street 1:38656 MEDICAL CENTER DR
Practice Address - Street 2:STE A
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-4483
Practice Address - Country:US
Practice Address - Phone:661-789-7693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA400622086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty