Provider Demographics
NPI:1770729022
Name:TAHA, ASHRAF A (ASH TAHA)
Entity type:Individual
Prefix:DR
First Name:ASHRAF
Middle Name:A
Last Name:TAHA
Suffix:
Gender:M
Credentials:ASH TAHA
Other - Prefix:
Other - First Name:ASH
Other - Middle Name:
Other - Last Name:TAHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ASH TAHA
Mailing Address - Street 1:120 TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-4729
Mailing Address - Country:US
Mailing Address - Phone:917-749-7474
Mailing Address - Fax:
Practice Address - Street 1:120 TUSTIN AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4729
Practice Address - Country:US
Practice Address - Phone:917-749-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1361782081P2900X, 208VP0014X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program