Individual
IBRAHIM TAHA ALDOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E. DUARTE RD., DEPARTMENT OF HEMATOLOGY & HCT, DUARTE, CA 91010-3012
(626) 256-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
(626) 775-3514
(626) 408-3911
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5582
NE
207RH0000X
Hematology (Internal Medicine) Physician
Primary
A11706
CA
207RH0003X
Hematology & Oncology Physician
A111706
CA
208M00000X
Hospitalist Physician
A111706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861692485
—
IA
01
—
1902846306
GROUP NPI
CA
01
—
GR0100430
GROUP MEDI-CAL
CA
01
—
W18762
GROUP MEDICARE
CA
Enumeration date
07/21/2007
Last updated
11/27/2023
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