Individual
DR. BURTON JARED TABAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
A162959
CA
2084N0400X
Neurology Physician
Primary
D84228
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14411782
CAQH #
NV
01
—
18940
NV MD LICENSE
NV
01
—
A162959
MEDICAL STATE LICENSE
CA
Enumeration date
04/08/2014
Last updated
03/07/2023
Update your record
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