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Individual

DR. DINA IBRAHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
6121 N THESTA ST STE 204, FRESNO, CA 93710-5294
(559) 554-2100
(559) 554-2114
Mailing address
7065 N. MAPLE AVE, STE 102, FRESNO, CA 93720
(559) 554-2100
(559) 554-2114

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
C51181
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4668885
ECFMG
01
C51181
CALIF. MEDICAL LICENSE
CA
01
CA1866078
INDIVIDUAL MEDICARE PTAN NUMBER
CA
01
ZZZ37565Z
GROUP PTAN
CA
Enumeration date
06/08/2006
Last updated
05/29/2025
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