MEDICARE: NADER LABIB

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst		CA

General Provider Information

NPI Number	:	1093233660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADER LABIB

Provider Business Mailing Address
First Line	:	10950 CHURCH ST APT 1415
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-8072
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10950 CHURCH STREET UNIT 1415
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730
Country	:	US
Telephone Number	:	951-992-2410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	02/09/2026

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