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Organization
ST. JOSEPH PULMONARY DIAGNOSTIC MEDICAL GROUP
Active
Organization
ST. JOSEPH PULMONARY DIAGNOSTIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN TABACK M.D. (PRESIDENT)
(818) 972-2626
Entity
Organization
Contact information
Practice address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
(818) 972-2626
(818) 842-5145
Mailing address
PO BOX 1551, GLENDALE, CA 91209-1551
(818) 972-2626
(818) 842-5145
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0049980
—
CA
Enumeration date
03/27/2007
Last updated
08/21/2012
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