Provider Demographics
NPI:1326097411
Name:TALEBI, PARVIZ SAGHEB (MD)
Entity Type:Individual
Prefix:DR
First Name:PARVIZ
Middle Name:SAGHEB
Last Name:TALEBI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20700 LAKE CHABOT RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5401
Mailing Address - Country:US
Mailing Address - Phone:510-889-1922
Mailing Address - Fax:510-889-5964
Practice Address - Street 1:20700 LAKE CHABOT RD
Practice Address - Street 2:SUITE 107
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5401
Practice Address - Country:US
Practice Address - Phone:510-889-1922
Practice Address - Fax:510-889-5964
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00221441OtherRAILROAD MEDICARE
00A837661Medicare ID - Type Unspecified
P00221441OtherRAILROAD MEDICARE