Active NPI
Alfred J Tabatzky, M.D.
- Otolaryngology Physician
- Mission Viejo, CA
National Provider Identifier
1356599476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- AFE21752
- Practice address
- 26951 Escondido LN
Mission Viejo, CA 92691-6020 - Phone
- (949) 305-7897
- NPI assigned
- Sep 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | AFE21752 | CA | Primary |
| Otolaryngology/Facial Plastic Surgery Physician | 207YX0905X | AFE21752 | CA |
Addresses
Primary practice location
26951 Escondido LN
Mission Viejo, CA 92691-6020
Mailing address
26951 Escondido Lane
Mission Viejo, CA 92691-6020
Phone (949) 305-7897
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AFE21752 | CA | MD | Otolaryngology/Facial Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220400000000",
"number": "1356599476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26951 ESCONDIDO LANE",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916020",
"telephone_number": "949-305-7897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26951 ESCONDIDO LN",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916020",
"telephone_number": "949-305-7897"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABATZKY",
"first_name": "ALFRED",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-09-03",
"last_updated": "2008-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "AFE21752",
"primary": true
},
{
"code": "207YX0905X",
"taxonomy_group": "",
"desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
"state": "CA",
"license": "AFE21752",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.