Provider Demographics
NPI:1679353940
Name:TABARIAI, EBBY
Entity Type:Individual
Prefix:
First Name:EBBY
Middle Name:
Last Name:TABARIAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826A S LOS ANGELES ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-3302
Mailing Address - Country:US
Mailing Address - Phone:310-748-7788
Mailing Address - Fax:310-629-5311
Practice Address - Street 1:826A S LOS ANGELES ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90014-3302
Practice Address - Country:US
Practice Address - Phone:310-748-7788
Practice Address - Fax:310-629-5311
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker