Provider Demographics
NPI:1962929778
Name:TELEOS OUTPATIENT SURGERY CENTER LLC
Entity type:Organization
Organization Name:TELEOS OUTPATIENT SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-375-1561
Mailing Address - Street 1:PO BOX 1526
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91031-1526
Mailing Address - Country:US
Mailing Address - Phone:626-375-1561
Mailing Address - Fax:310-988-2909
Practice Address - Street 1:836 S ARROYO PKWY STE A
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3212
Practice Address - Country:US
Practice Address - Phone:626-375-1561
Practice Address - Fax:310-988-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty