Healthcare Provider Details

I. General information

NPI: 1487895280
Provider Name (Legal Business Name): CHRISTINE IBRAHIM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8383 WILSHIRE BLVD STE 603
BEVERLY HILLS CA
90211-2434
US

IV. Provider business mailing address

8383 WILSHIRE BLVD STE 603
BEVERLY HILLS CA
90211-2434
US

V. Phone/Fax

Practice location:
  • Phone: 310-551-2612
  • Fax: 310-304-3985
Mailing address:
  • Phone: 310-551-2612
  • Fax: 310-304-3985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA87619
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: