Organization
WEST REGIONAL CARDIOTHORACIC & VASCULAR SURGEONS W R VEIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD A TABAIE DO (PRESIDENT/OWNER)
(941) 720-0731
Entity
Organization
Contact information
Practice address
5475 E LA PALMA AVE, SUITE 204, ANAHEIM, CA 92807-2075
(941) 720-0731
Mailing address
5475 E LA PALMA AVE, SUITE 204, ANAHEIM, CA 92807-2075
(941) 720-0731
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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