Provider Demographics
NPI:1831754449
Name:TALIULU, LUTERU TISEGA
Entity type:Individual
Prefix:
First Name:LUTERU
Middle Name:TISEGA
Last Name:TALIULU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 SAN JERONIMO DR STE 310
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2870
Mailing Address - Country:US
Mailing Address - Phone:907-793-3200
Mailing Address - Fax:907-793-3250
Practice Address - Street 1:3149 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3106
Practice Address - Country:US
Practice Address - Phone:907-793-3629
Practice Address - Fax:907-868-8948
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-08
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management