Provider Demographics
NPI:1013103704
Name:TAHZIB, RASHEL J (DO)
Entity Type:Individual
Prefix:DR
First Name:RASHEL
Middle Name:J
Last Name:TAHZIB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11633 SAN VICENTE BLVD
Mailing Address - Street 2:STE 107
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6512
Mailing Address - Country:US
Mailing Address - Phone:714-624-5969
Mailing Address - Fax:714-531-5581
Practice Address - Street 1:11633 SAN VICENTE BLVD
Practice Address - Street 2:STE 107
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6512
Practice Address - Country:US
Practice Address - Phone:310-979-3434
Practice Address - Fax:310-979-9992
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2016-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9090207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEN158AOtherEN158A