Healthcare Provider Details

I. General information

NPI: 1023011038
Provider Name (Legal Business Name): MICHAEL N KABAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22501 CHASE APT 1203
ALISO VIEJO CA
92656-6096
US

IV. Provider business mailing address

22501 CHASE APT 1203
ALISO VIEJO CA
92656-6096
US

V. Phone/Fax

Practice location:
  • Phone: 949-239-8844
  • Fax: 949-239-8844
Mailing address:
  • Phone: 949-239-8844
  • Fax: 949-239-8844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA053581
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: