Organization
PARHAM TABIBIAN MD INC
Active
Parent organization
PARHAM TABIBIAN MD INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARHAM TABIBIAN MD INC
Authorized official
MICHAEL P. TABIBIAN MD (MEDICAL DIRECTOR)
(310) 738-6006
Entity
Organization
Contact information
Practice address
30300 AGOURA RD STE 200, AGOURA HILLS, CA 91301-5413
(818) 706-3744
Mailing address
3851 KATELLA AVE STE 105, LOS ALAMITOS, CA 90720-3389
(562) 799-3330
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB222113
PTAN
CA
Enumeration date
10/26/2018
Last updated
10/26/2018
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