Individual
STEVEN MICHAEL TABACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S. BUENA VISTA ST., SUITE 440, BURBANK, CA 91505
(818) 842-4819
(818) 842-2086
Mailing address
201 S. BUENA VISTA ST., SUITE 440, BURBANK, CA 91505
(818) 842-4819
(818) 842-2086
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
G062972
CA
207RP1001X
Pulmonary Disease Physician
Primary
G062972
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290004747
PTAN (RXR MEDICARE)
—
05
—
ZZZ77466Z
—
CA
Enumeration date
02/23/2006
Last updated
02/14/2014
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