Provider Demographics
NPI:1942661624
Name:SINA TEBI MD INC
Entity Type:Organization
Organization Name:SINA TEBI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-222-2300
Mailing Address - Street 1:10535 WILSHIRE BLVD
Mailing Address - Street 2:#1514
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4503
Mailing Address - Country:US
Mailing Address - Phone:661-222-2300
Mailing Address - Fax:844-273-2445
Practice Address - Street 1:23938 LYONS AVENUE
Practice Address - Street 2:#204
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-222-2300
Practice Address - Fax:844-273-2445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115277207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty