Healthcare Provider Details

I. General information

NPI: 1992763528
Provider Name (Legal Business Name): ZOHREH L TABATABAI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 CLEMENT ST. MAIL STOP 113-B UNIVERSITY HOSPITAL
SAN FRANCISCO CA
94121
US

IV. Provider business mailing address

4150 CLEMENT ST MAIL STOP 113-B
SAN FRANCISCO CA
94121-1545
US

V. Phone/Fax

Practice location:
  • Phone: 415-221-4810
  • Fax: 415-750-6947
Mailing address:
  • Phone: 415-221-4810
  • Fax: 415-750-6947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA74106
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number159640
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: