Provider Demographics
NPI:1235287707
Name:ERFANI, TAYEBEH (LM)
Entity Type:Individual
Prefix:MRS
First Name:TAYEBEH
Middle Name:
Last Name:ERFANI
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12722 GOETHE PL
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1419
Mailing Address - Country:US
Mailing Address - Phone:818-366-1400
Mailing Address - Fax:
Practice Address - Street 1:8215 VAN NUYS BLVD STE 104
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4855
Practice Address - Country:US
Practice Address - Phone:818-994-4010
Practice Address - Fax:818-994-4033
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM124176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1235287707Medicaid