MEDICARE: PEYMAN TABRIZI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	A61388	CA

General Provider Information

NPI Number	:	1154362499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEYMAN TABRIZI

Provider Business Mailing Address
First Line	:	PO BOX 1161
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92781-1161
Country	:	US
Telephone Number	:	949-448-0302
Fax Number	:	949-448-0335

Provider Business Practice Location Address
First Line	:	1220 HEMLOCK WAY STE 205
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-3655
Country	:	US
Telephone Number	:	714-834-0439
Fax Number	:	714-953-3425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	12/29/2020

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Directions to “ PEYMAN TABRIZI ” Practice Location

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