Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | CP15744 | CA |
N | 103T00000X | Psychologist | CP15744 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | CP15744 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | CP15744 | CA |
N | 103G00000X | Clinical Psychologist | CP15744 | CA |
N | 103TC0700X | Clinical Psychologist | CP15744 | CA |
N | 103TC1900X | Counseling Psychologist | CP15744 | CA |
N | 103TH0100X | Health Service | CP15744 | CA |
N | 103TP0814X | Psychoanalysis | CP15744 | CA |
N | 103TP2701X | Group Psychotherapist | CP15744 | CA |
N | 103TR0400X | Rehabilitation Psychologist | CP15744 | CA |
NPI | 1770642134 |
---|---|
Provider Name | Dr. Tomer Anbar |
First Address | San Diego, CA 92130-2116 |
Second Address | La Jolla, CA 92037-2107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |