Individual
DEANAH A JIBRIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
19330 JESSE LN STE 100, RIVERSIDE, CA 92508-5077
(951) 847-8000
Mailing address
3212 SAINT GEORGES DR, PLANO, TX 75093-4719
(972) 867-4880
(972) 867-4881
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
20A17489
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
J9718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060DF
BLUE CROSS
TX
05
—
030902301
—
TX
01
—
2362989
AETNA
TX
01
—
2544257
CIGNA
—
Enumeration date
04/14/2006
Last updated
02/22/2020
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