MEDICARE: GEORGE IBRAHIM GIRGIS 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	208D00000X	General Practice Physician	A43715	CA

General Provider Information

NPI Number	:	1649284670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE IBRAHIM GIRGIS M.D.

Provider Business Mailing Address
First Line	:	14004 FREMANTLE CT
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93314-9298
Country	:	US
Telephone Number	:	661-589-6661
Fax Number	:	661-637-1112

Provider Business Practice Location Address
First Line	:	14004 FREMANTLE CT
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93314-9298
Country	:	US
Telephone Number	:	661-589-6661
Fax Number	:	661-637-1112

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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