Individual
BRIAN J TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
136 N 3RD ST, LOMPOC, CA 93436-7002
(805) 736-1253
(805) 736-3193
Mailing address
136 N 3RD ST, LOMPOC, CA 93436-7002
(805) 736-1253
(805) 736-3193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A61051
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ37313Z
—
CA
Enumeration date
07/31/2006
Last updated
04/22/2008
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