Individual
ANTHONY RYAN TABET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1250 16TH ST # C2304, SANTA MONICA, CA 90404-1249
(310) 319-4698
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A16876
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A16876
STATE LICENSE
CA
Enumeration date
03/28/2017
Last updated
03/07/2023
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