Provider Demographics
NPI:1346286663
Name:TABAIE, HAROLD A (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:A
Last Name:TABAIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18375 VENTURA BLVD # 539
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:714-777-1012
Mailing Address - Fax:949-502-8887
Practice Address - Street 1:400 N FORD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1122
Practice Address - Country:US
Practice Address - Phone:818-577-9082
Practice Address - Fax:949-502-8887
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2015-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5710208G00000X
CA20A4475208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC52794Medicare UPIN