Provider Demographics
NPI:1932495058
Name:HYPERBARIC OXYGEN THERAPY MEDICAL CENTER
Entity Type:Organization
Organization Name:HYPERBARIC OXYGEN THERAPY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TABIBIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-344-1329
Mailing Address - Street 1:PO BOX 49911
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-0911
Mailing Address - Country:US
Mailing Address - Phone:818-344-1329
Mailing Address - Fax:818-344-1390
Practice Address - Street 1:18065 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3517
Practice Address - Country:US
Practice Address - Phone:818-344-1329
Practice Address - Fax:818-344-1390
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:F&M RADIOLOGY MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-27
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
204C00000X, 2083P0011X, 208D00000X
CAA405592084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty