| Doctor Name: | HOOSHANG TABIBIAN |
| NPI Number: | 1184840746 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A40845 |
| Business Practice Address: | 11611 San Vicente Blvd Los Angeles, CA - 900495106 |
| Business Phone Number: | 3104476060 |
| Business Fax Number: | |
| Mailing Address: | 10560 Wilshire Blvd, Suite 301 LOS ANGELES |
| State: | CA |
| Postal Code: | 900244580 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A40845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |