Healthcare Provider Details

I. General information

NPI: 1164601076
Provider Name (Legal Business Name): MAJID TALEBI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 ENBORG CT UNIT 100
SAN JOSE CA
95128-2645
US

IV. Provider business mailing address

871 ENBORG CT UNIT 100
SAN JOSE CA
95128-2645
US

V. Phone/Fax

Practice location:
  • Phone: 408-793-2147
  • Fax: 408-885-7544
Mailing address:
  • Phone: 408-793-2147
  • Fax: 408-885-7544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number41768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: