Provider Demographics
NPI:1891028239
Name:WEST REGIONAL CARDIOTHORACIC & VASCULAR SURGEONS W R VEIN CENTER
Entity Type:Organization
Organization Name:WEST REGIONAL CARDIOTHORACIC & VASCULAR SURGEONS W R VEIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:A
Authorized Official - Last Name:TABAIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-720-0731
Mailing Address - Street 1:5850 CANOGA AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6554
Mailing Address - Country:US
Mailing Address - Phone:805-910-7390
Mailing Address - Fax:
Practice Address - Street 1:4527 E CESAR CHAVEZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1116
Practice Address - Country:US
Practice Address - Phone:323-262-9299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty