Provider Demographics
NPI:1427067230
Name:SABA, TABASSUM (MD)
Entity type:Individual
Prefix:
First Name:TABASSUM
Middle Name:
Last Name:SABA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3324 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-5007
Mailing Address - Country:US
Mailing Address - Phone:417-439-4048
Mailing Address - Fax:417-347-7608
Practice Address - Street 1:9990 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3542
Practice Address - Country:US
Practice Address - Phone:909-358-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04293332084N0400X
MO20010265872084N0400X, 2084P0800X
MN713772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205877707Medicaid
MO228746563OtherBNDD
OK100850130AMedicaid
KS100426590BMedicaid
MO228746563OtherBNDD
OK100850130AMedicaid
MOH65166Medicare UPIN