# DR. MOHSEN TANBAKOOCHI MOGHADDAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1720010234
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | A46373 | CA | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | A46373 | CA | — |
| 208D00000X | General Practice Physician | A46373 | CA | Yes |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 05/29/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A463732 | — | CA |