Provider Demographics
NPI:1902822760
Name:BITTAR, TAREK (MD)
Entity Type:Individual
Prefix:
First Name:TAREK
Middle Name:
Last Name:BITTAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25751 MCBEAN PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3701
Mailing Address - Country:US
Mailing Address - Phone:661-253-3399
Mailing Address - Fax:661-253-3999
Practice Address - Street 1:25751 MCBEAN PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3701
Practice Address - Country:US
Practice Address - Phone:661-253-3399
Practice Address - Fax:661-253-3999
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71373174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA71373AMedicare PIN
I07807Medicare UPIN