Organization
EMAD IBRAHIM, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMAD IBRAHIM M.D. (OWNER)
(909) 557-3983
Entity
Organization
Contact information
Practice address
245 TERRACINA BLVD STE 206, REDLANDS, CA 92373-4867
(909) 793-4336
(909) 793-3325
Mailing address
527 ACACIA CT, REDLANDS, CA 92373-5667
(909) 557-3983
(909) 335-6162
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
A51062
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A510620
—
CA
Enumeration date
04/22/2016
Last updated
07/15/2022
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