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General NPI Number Information
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NPI Number | 1114168879
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Entity Type | Organization
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Legal Business Name | GHASAN M TABEL MD INC
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Dates
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Enumeration Date | 03/10/2009
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 160 W FOOTHILL PKWY SUITE 105-348
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City | CORONA
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State | CA
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Zip | 92882-8545
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Country | US
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Telephone | 951-999-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 160 W FOOTHILL PKWY SUITE 105-348
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City | CORONA
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State | CA
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Zip | 92882-8545
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Country | US
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Telephone | 951-999-9999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GHASAN M TABEL
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Credential | MD
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Telephone | 951-999-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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