Provider Demographics
NPI:1992149843
Name:HILAL, TARIQ IYAD (DO)
Entity type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:IYAD
Last Name:HILAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11769
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-1769
Mailing Address - Country:US
Mailing Address - Phone:562-534-2606
Mailing Address - Fax:562-534-2604
Practice Address - Street 1:3771 KATELLA AVE STE 107
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3111
Practice Address - Country:US
Practice Address - Phone:562-534-2606
Practice Address - Fax:562-534-2604
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A156222081S0010X, 208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation