Individual
MRS. AMAL SHOUKRY IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
565 N. MT. VERNON AVE, SAN BERNARDINO, CA 92411
(909) 884-9091
(909) 383-7013
Mailing address
PO BOX 12209, SUITE #230, SAN BERNARDINO, CA 92423-2209
(909) 890-0407
(909) 890-0575
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A53803
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A538030
MEDI-CAL
CA
Enumeration date
09/21/2006
Last updated
03/04/2016
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