Provider Demographics
NPI:1902498439
Name:TELEMEDORA, PC
Entity Type:Organization
Organization Name:TELEMEDORA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUBAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, FCCP
Authorized Official - Phone:650-687-7368
Mailing Address - Street 1:1250 BORREGAS AVE # 62
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-1309
Mailing Address - Country:US
Mailing Address - Phone:650-687-7368
Mailing Address - Fax:
Practice Address - Street 1:1250 BORREGAS AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94089-1309
Practice Address - Country:US
Practice Address - Phone:650-687-7368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty