Provider Demographics
NPI:1710771001
Name:KIANA TABA, MD, INC.
Entity type:Organization
Organization Name:KIANA TABA, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TABA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-438-3848
Mailing Address - Street 1:320 SUPERIOR AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-2742
Mailing Address - Country:US
Mailing Address - Phone:949-438-3848
Mailing Address - Fax:
Practice Address - Street 1:320 SUPERIOR AVE STE 310
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-2742
Practice Address - Country:US
Practice Address - Phone:949-438-3848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty