Healthcare Provider Details

I. General information

NPI: 1073304069
Provider Name (Legal Business Name): TAMI INBAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 BAKER ST STE 103
COSTA MESA CA
92626-4105
US

IV. Provider business mailing address

1190 BAKER ST STE 103
COSTA MESA CA
92626-4105
US

V. Phone/Fax

Practice location:
  • Phone: 714-668-2525
  • Fax: 714-668-2530
Mailing address:
  • Phone: 714-668-2525
  • Fax: 714-668-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMI INBAR
Title or Position: OWNER
Credential: MD
Phone: 949-202-8409