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General NPI Number Information
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NPI Number | 1437100351
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Entity Type | Individual
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Provider Name | MOSHE TABAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 11/26/2008
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Provider Practice Location Address
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Address Line | 801 S. CHEVY CHASE DR. STE 106
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City | GLENDALE
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State | CA
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Zip | 91205-4431
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Country | US
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Telephone | 818-265-2275
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Fax | 818-291-0818
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Provider Business Mailing Address
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Address Line | P.O. BOX 3098
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City | TORRANCE
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State | CA
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Zip | 90510-3098
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Country | US
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Telephone | 310-792-3914
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Fax | 310-792-3802
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A40257
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License Number State | CA
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