Individual
DR. EHSAN TABARAEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
609 E ORANGEBURG AVE, SUITE 201, MODESTO, CA 95350-5512
(209) 572-3224
(209) 572-4528
Mailing address
609 E ORANGEBURG AVE, SUITE 201, MODESTO, CA 95350-5512
(209) 572-3224
(209) 572-4528
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A114899
CA
207XX0801X
Orthopaedic Trauma Physician
A114899
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/30/2009
Last updated
05/12/2015
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