Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | AFE21752 | CA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | AFE21752 | CA |
NPI | 1356599476 |
---|---|
Provider Name | Dr. Alfred J Tabatzky |
First Address | Mission Viejo, CA 92691-6020 |
Second Address | Mission Viejo, CA 92691-6020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 03/09/2008 |