Organization
PARHAM TABIBIAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TABIBIAN MD (OWNER)
(310) 738-6006
Entity
Organization
Contact information
Practice address
3851 KATELLA AVE, SUITE 105, LOS ALAMITOS, CA 90720-3309
(562) 799-3330
(562) 799-3399
Mailing address
2733 AQUA VERDE CIR, LOS ANGELES, CA 90077-1502
(310) 738-6006
(818) 706-3744
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W20560
MEDICARE ID
CA
Enumeration date
12/28/2006
Last updated
10/24/2019
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