Dr. Matthew Tabanfar
Dentist in West Covina, CA. Individual provider (NPI-1).
NPI number1760044366
StatusActive
Last updated in NPPESJul 3, 2019
Details
- NPI
- 1760044366
- Entity type
- Individual (NPI-1)
- Name
- Dr. Matthew Tabanfar
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 3, 2019
- Last updated
- Jul 3, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 103913 | CA | Yes |
Practice location
2225 E Garvey Ave NWest Covina, CA 91791-1500
Phone 626-412-0200
Mailing address
4404 Nogales DrTarzana, CA 91356-5120
Phone 818-383-6050
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