| Organization Name: | MONA TABIB MD INC |
| NPI Number: | 1003040478 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MONA TABIB (PRESIDENT) |
| Mailing Address: | 16661 Ventura Blvd Suite 211 Encino |
| State: | CA US |
| Postal Code: | 914361914 |
| Phone Number: | 8187897893 |
| Fax Number: | 8187892346 |
| NPI Enumeration Date: | 05/13/2009 |
| NPI Last Update Date: | 05/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | A40287 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |