Provider Demographics
NPI:1407835325
Name:TALEBIAN, MOJDEH (MD)
Entity Type:Individual
Prefix:MS
First Name:MOJDEH
Middle Name:
Last Name:TALEBIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 WHIPPLE AVE
Mailing Address - Street 2:#4
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062
Mailing Address - Country:US
Mailing Address - Phone:650-216-9000
Mailing Address - Fax:650-365-1157
Practice Address - Street 1:2950 WHIPPLE AVE
Practice Address - Street 2:#4
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-216-9000
Practice Address - Fax:650-365-1157
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA644950207LC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G90993Medicare UPIN
CAZZZ30825ZMedicare ID - Type Unspecified