MEDICARE: HOSSEIN TABRIZIANI MD

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	174400000X	Specialist	A78291	CA
2	207RN0300X	Nephrology Physician	A78291	CA
3	174400000X	Specialist	MD038954	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A78291	OTHER	CA	CA LICENSE

General Provider Information

NPI Number	:	1427136332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOSSEIN TABRIZIANI MD

Provider Business Mailing Address
First Line	:	9610 GRANITE RIDGE DR STE B
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-2684
Country	:	US
Telephone Number	:	858-810-8000
Fax Number	:	858-346-1024

Provider Business Practice Location Address
First Line	:	8010 FROST ST STE 510
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4284
Country	:	US
Telephone Number	:	858-637-4700
Fax Number	:	858-637-4701

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/30/2018

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