=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235287707
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAYEBEH ERFANI LM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2007
-----------------------------------------------------
Last Update Date | 01/17/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8215 VAN NUYS BLVD STE 104
-----------------------------------------------------
City | PANORAMA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91402-4855
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-994-4010
-----------------------------------------------------
Fax | 818-994-4033
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12722 GOETHE PL
-----------------------------------------------------
City | GRANADA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91344-1419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-366-1400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | LM124
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------