Organization
WALEED IBRAHIM M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALEED IBRAHIM M.D. (OWNER)
(209) 334-7559
Entity
Organization
Contact information
Practice address
999 S FAIRMONT AVE, STE. 115, LODI, CA 95240-5100
(209) 334-7559
(209) 334-7459
Mailing address
999 S FAIRMONT AVE, STE. 115, LODI, CA 95240-5100
(209) 334-7559
(209) 334-7459
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A77739
CA
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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