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General NPI Number Information
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NPI Number | 1568907863
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Entity Type | Organization
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Legal Business Name | MOSTAFA TABASSOMI MD INC
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Dates
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Enumeration Date | 12/22/2016
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Last Update Date | 02/06/2023
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Provider Practice Location Address
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Address Line | 23838 VALENCIA BLVD STE 304
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City | VALENCIA
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State | CA
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Zip | 91355-5319
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Country | US
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Telephone | 661-430-9030
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Fax | 661-430-9030
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Provider Business Mailing Address
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Address Line | 23838 VALENCIA BLVD STE 304
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City | VALENCIA
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State | CA
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Zip | 91355-5319
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Country | US
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Telephone | 661-430-9030
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Fax | 661-430-9020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOSTAFA TABASSOMI
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Credential | M.D.
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Telephone | 661-430-9030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A106160
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A106160
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A106160
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License Number State | CA
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