Provider Demographics
NPI:1780756825
Name:TBITTAR INC
Entity type:Organization
Organization Name:TBITTAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAREK
Authorized Official - Middle Name:
Authorized Official - Last Name:BITTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-253-3399
Mailing Address - Street 1:25751 MCBEAN PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3701
Mailing Address - Country:US
Mailing Address - Phone:661-253-3399
Mailing Address - Fax:661-253-3999
Practice Address - Street 1:25751 MCBEAN PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3701
Practice Address - Country:US
Practice Address - Phone:661-253-3399
Practice Address - Fax:661-253-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71373207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI07807Medicare UPIN
CAA71373Medicare ID - Type Unspecified
CAW20914Medicare PIN