Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kira Ann Tellache, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1104441021

Kira Ann Tellache, PHYSICIANASSISTANT is a Physician Assistant in LA Mesa, California. Graduated from Tufts University School of Medicine in 2020, 6 years ago. Practices with Sun Medical Group Inc, an 18-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Trained at
Tufts University School of Medicine
Licensed in
CA
In the registry since
2020
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Practice location Address checks out

8860 Center Dr Ste 300
LA Mesa, CA 91942-7001
Phone: (619) 462-1670
Fax: (619) 462-3209
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4520 Executive Dr Ste 325, San Diego, CA 92121-3087 — (858) 346-2065
  • 3095 Old Conejo Rd Ste 200, Thousand Oaks, CA 91320-2130 — (888) 367-1850

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 57882 (CA)

Record details

NPI number1104441021
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedJune 16, 2020
Last updated in NPPESAugust 3, 2022
Certification dateAugust 3, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Sun Medical Group Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in LA Mesa