| Dr Edwardo Tellez, MD | |
|
16510 Bloomfield Ave, Cerritos, CA 90703-9346 | |
| (562) 229-0902 | |
| (562) 229-0952 |
| Full Name | Dr Edwardo Tellez |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 16510 Bloomfield Ave, Cerritos, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104833516 | NPI | - | NPPES |
| 00G63350 | Other | CA | BLUE SHIELD |
| 00G63350C | Medicaid | CA | |
| 370020277 | Other | CA | MEDICARE RAILROAD |
| 370020277 | Other | CA | RAILROAD MEDICARE |
| 00G633500 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | G63350 (California) | Secondary |
| 208000000X | Pediatrics | 63350 (California) | Primary |
| Entity Name | Pioneer Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548303589 PECOS PAC ID: 1759317696 Enrollment ID: O20050712001246 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Edwardo Tellez, MD 75 Remittance Drive Dept 6008, Chicago, CA 60675-6008 Ph: (562) 282-1419 | Dr Edwardo Tellez, MD 16510 Bloomfield Ave, Cerritos, CA 90703-9346 Ph: (562) 229-0902 |
Sowmya Ananthanarayanan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 13031 Sutton St, Cerritos, CA 90703 Phone: 949-892-5357 | |
Cecilia Santiago Carigma, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 18821 Pioneer Blvd, Suite D, Cerritos, CA 90701 Phone: 562-403-0400 |