MEDICARE: DR. AMBER TABARES NMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath

General Provider Information

NPI Number	:	1053723015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER TABARES NMD

Provider Business Mailing Address
First Line	:	2210 S MILL AVE STE 9
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2153
Country	:	US
Telephone Number	:	623-295-9671
Fax Number	:	866-418-4368

Provider Business Practice Location Address
First Line	:	2210 S MILL AVE STE 9
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2153
Country	:	US
Telephone Number	:	623-295-9671
Fax Number	:	866-418-4368

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	06/03/2016

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