Individual
HABIB ALI ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 W COVINA BLVD, STE 103, SAN DIMAS, CA 91773-3200
(909) 592-2145
(909) 599-6217
Mailing address
1330 W COVINA BLVD, STE 103, SAN DIMAS, CA 91773-3200
(909) 592-2145
(909) 599-6217
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
A43523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A43523
—
CA
Enumeration date
04/26/2006
Last updated
11/05/2007
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