| Siamak Tabib Md Inc | |
|
8631 W 3rd St Ste 1015e Los Angeles CA 90048-5925 | |
| (310) 652-4472 | |
| (310) 358-2266 |
| Full Name | Siamak Tabib Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8631 W 3rd St Ste 1015e, Los Angeles, California |
| Authorized Official Name and Position | Siamak Tabib (PRESIDENT) |
| Authorized Official Contact | 3106524472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Siamak Tabib Md Inc 8631 W 3rd St Ste 1015e Los Angeles CA 90048-5925 Ph: (310) 652-4472 | Siamak Tabib Md Inc 8631 W 3rd St Ste 1015e Los Angeles CA 90048-5925 Ph: (310) 652-4472 |
| NPI Number | 1265635536 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 12/31/2012 |
| Medicare PECOS PAC ID | 5991745382 |
|---|---|
| Medicare Enrollment ID | O20050504001237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265635536 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (California) | Primary |
| Provider Name | Lidija M Petrovic |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457326266 PECOS PAC ID: 9234159344 Enrollment ID: I20081205000200 |
| Provider Name | Siamak Tabib |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063555845 PECOS PAC ID: 9537109921 Enrollment ID: I20120614000045 |
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