# MEHRAN TABAN M.D. INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Macula Retina Vitreous Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104221035
- **Authorized official:** DR. MEHRAN TABAN M.D. (PHYSICIAN)
- **Authorized official phone:** (424) 247-9090

## Contact information

- **Practice address:** 20528 HAWTHORNE BLVD STE 201, TORRANCE, CA 90503-3271
- **Practice address phone:** (424) 247-9090
- **Practice address fax:** (424) 247-9095
- **Mailing address:** 20528 HAWTHORNE BLVD STE 201, TORRANCE, CA 90503-3271
- **Mailing address phone:** (424) 247-9090
- **Mailing address fax:** (424) 247-9095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | A108546 | CA | Yes |

## Other

- **Enumeration date:** 11/04/2014
- **Last updated:** 01/30/2023