Organization
MONA TABIB MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONA TABIB M.D. (PRESIDENT)
(818) 789-7893
Entity
Organization
Contact information
Practice address
16661 VENTURA BLVD, SUITE 211, ENCINO, CA 91436-1914
(818) 789-7893
(818) 789-2346
Mailing address
4520 CAMINITO PL, TARZANA, CA 91356-4720
(818) 789-7893
(818) 789-2346
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A40287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A402870
—
CA
Enumeration date
05/13/2009
Last updated
05/18/2020
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