Jared Tallo | San Diego, CA • PECOS Search

Jared Tallo

General Practice

Allopathic & Osteopathic Physicians

34800 Bob Wilson Dr, San Diego, CA 92134-1098

(619) 643-8100 (585) 329-2407

PECOS Enrollment

Based on the most recent information from CMS, provider Jared Tallo does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1063167468
Provider Type
Individual
Full Name
Tallo, Jared
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
2/15/2022
Last Updated
12/9/2025

Contact Information

Practice Location

34800 Bob Wilson Dr, San Diego, CA 92134-1098

(619) 532-7272

Mailing Location

10285 Rookwood Dr, San Diego, CA 92131-1612

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License 0101279363 Virginia