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General NPI Number Information
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NPI Number | 1336382126
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Entity Type | Organization
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Legal Business Name | HERBERT D. TARLOW,MD INC. PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 04/09/2009
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Provider Practice Location Address
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Address Line | 215 N STATE COLLEGE BLVD SUITE B
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City | ANAHEIM
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State | CA
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Zip | 92806-2913
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Country | US
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Telephone | 714-772-2210
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Fax | 714-774-2826
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Provider Business Mailing Address
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Address Line | 215 N STATE COLLEGE BLVD SUITE B
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City | ANAHEIM
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State | CA
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Zip | 92806-2913
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Country | US
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Telephone | 714-772-2210
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Fax | 714-774-2826
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. HERBERT DAVID TARLOW
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Credential | M.D.
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Telephone | 714-772-2210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A28168
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License Number State | CA
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