Individual
MARK IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1120 VIEWCREST CT, CORONA, CA 92882-8908
(347) 817-0674
Mailing address
1120 VIEWCREST CT, CORONA, CA 92882-8908
(347) 817-0674
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/19/2018
Last updated
02/04/2020
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