Healthcare Provider Details

I. General information

NPI: 1447172002
Provider Name (Legal Business Name): MR. IBRAHIM MARABEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29744 ANDROMEDA ST
MURRIETA CA
92563-2770
US

IV. Provider business mailing address

29744 ANDROMEDA ST
MURRIETA CA
92563-2770
US

V. Phone/Fax

Practice location:
  • Phone: 951-541-6461
  • Fax:
Mailing address:
  • Phone: 951-541-6461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number7ZAC455
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: