Provider Demographics
NPI:1700572716
Name:TALEBIAN, MAHYAR (DPT)
Entity type:Individual
Prefix:DR
First Name:MAHYAR
Middle Name:
Last Name:TALEBIAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17208 LUVERNE PL
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3932
Mailing Address - Country:US
Mailing Address - Phone:310-962-8238
Mailing Address - Fax:
Practice Address - Street 1:1351 CORPORATE BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-7102
Practice Address - Country:US
Practice Address - Phone:775-825-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050086225100000X
NV6269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist