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Individual

EBRAHIM HAROON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 WOODRUFF CIR, SUITE 4105, ATLANTA, GA 30322-0001
(404) 712-2890
Mailing address
101 WOODRUFF CIR, SUITE 4105, ATLANTA, GA 30322-0001
(404) 712-2890

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
59733
GA
2084P0800X
Psychiatry Physician
C51046
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00C510460
MEDI-CAL
CA
Enumeration date
07/09/2006
Last updated
01/25/2019
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