Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A104733 | CA |
N | 208D00000X | General Practice Physician | A104733 | CA |
NPI | 1265675615 |
---|---|
Provider Name | Dr. Ramona Tabib |
First Address | Beverly Hills, CA 90211-3302 |
Second Address | Encino, CA 91436-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2009 |
Last Update Date | 27/10/2021 |