Brian Eijiro Tabata, PA-C

NPI #1437534005 in Big Bear Lake, California

Provider Information

NPI Number: 1437534005
Entity Type: Individual
Name: Brian Eijiro Tabata, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 24, 2015
Last Updated: Oct 12, 2015

Practice Location

Address: 41949 BIG BEAR BLVD
City: Big Bear Lake
State: California
ZIP Code: 92315
Phone: (909) 878-3696

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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