Individual
DR. MOHAMMAD JABER KABBESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3939 J ST STE 320, SACRAMENTO, CA 95819-3666
(916) 733-5995
(916) 281-3862
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
(916) 861-1486
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
37101
IA
207R00000X
Internal Medicine Physician
C54090
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
37101
IA
207RI0200X
Infectious Disease Physician
37101
IA
207RI0200X
Infectious Disease Physician
Primary
C54090
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356367809
—
IA
05
—
271097800
—
FL
01
—
48004
BLUE CROSS
FL
01
—
C54090
MEDICAL STATE LICENSE
CA
Enumeration date
07/15/2006
Last updated
03/16/2020
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