Provider Demographics
NPI:1992386585
Name:EL NABLI, TAREK
Entity Type:Individual
Prefix:MR
First Name:TAREK
Middle Name:
Last Name:EL NABLI
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 1:24012 CALLE DE LA PLATA STE 400
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7623
Mailing Address - Country:US
Mailing Address - Phone:833-247-9111
Mailing Address - Fax:
Practice Address - Street 1:24012 CALLE DE LA PLATA STE 400
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7623
Practice Address - Country:US
Practice Address - Phone:833-247-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care