Healthcare Provider Details

I. General information

NPI: 1831521590
Provider Name (Legal Business Name): MR. ORION TARABAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 OCEAN AVE
SAN FRANCISCO CA
94112-1727
US

IV. Provider business mailing address

506 5TH AVE
SAN FRANCISCO CA
94118-3929
US

V. Phone/Fax

Practice location:
  • Phone: 415-452-2200
  • Fax:
Mailing address:
  • Phone: 917-612-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: