Healthcare Provider Details

I. General information

NPI: 1780756825
Provider Name (Legal Business Name): TBITTAR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25751 MCBEAN PKWY SUITE 200
VALENCIA CA
91355-3701
US

IV. Provider business mailing address

25751 MCBEAN PKWY SUITE 200
VALENCIA CA
91355-3701
US

V. Phone/Fax

Practice location:
  • Phone: 661-253-3399
  • Fax: 661-253-3999
Mailing address:
  • Phone: 661-253-3399
  • Fax: 661-253-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA71373
License Number StateCA

VIII. Authorized Official

Name: DR. TAREK BITTAR
Title or Position: OWNER
Credential: MD
Phone: 661-253-3399