MEDICARE: DR. SAMI I JABARA M.D.

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	207VE0102X	Reproductive Endocrinology Physician	C54168	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A082	OTHER	NM	TRIWEST
2	8G0821	OTHER	TX	BC/BS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	91192	OTHER	NM	PRESBYTERIAN COMMERCIAL
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	141847100	OTHER	TX	FIRSTCARE COMMERCIAL
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	87833Z	OTHER	TX	HMO BLUE
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508856220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMI I JABARA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	213-975-9990
Fax Number	:	213-975-9997

Provider Business Practice Location Address
First Line	:	1275 WILSHIRE BLVD
Second Line	:	SUITE 1400
City	:	LOS ANGELES
State	:	CA
Zip	:	90017-3901
Country	:	US
Telephone Number	:	213-975-9990
Fax Number	:	213-975-9997

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	12/01/2021

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Directions to “ DR. SAMI I JABARA M.D.” Practice Location

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