Provider Demographics
NPI:1659687994
Name:TALYA, EDWARD DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DANIEL
Last Name:TALYA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9288 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-5857
Mailing Address - Country:US
Mailing Address - Phone:916-270-6977
Mailing Address - Fax:916-823-3597
Practice Address - Street 1:9288 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-5857
Practice Address - Country:US
Practice Address - Phone:916-270-6977
Practice Address - Fax:916-823-3597
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2025-0487208000000X
CAA123964174400000X
OK403852080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK201090400AMedicaid
CA882078242Medicaid
CA1033857578Medicaid