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General NPI Number Information
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NPI Number | 1164752242
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Entity Type | Organization
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Legal Business Name | TABATABAI LLC
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Dates
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Enumeration Date | 01/12/2010
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Last Update Date | 01/12/2010
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Provider Practice Location Address
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Address Line | 2255 CONTRA COSTA BLVD STE 305
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City | PLEASANT HILL
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State | CA
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Zip | 94523-3784
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Country | US
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Telephone | 925-405-9626
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 CONTRA COSTA BLVD STE 305
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City | PLEASANT HILL
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State | CA
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Zip | 94523-3784
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEHER F TABATABAI
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Credential | MD
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Telephone | 925-405-9626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | A38282
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License Number State | CA
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