Healthcare Provider Details

I. General information

NPI: 1528267010
Provider Name (Legal Business Name): JEFFREY HOWARD BELABIN PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23530 HAWTHORNE BLVD STE 290
TORRANCE CA
90505-4713
US

IV. Provider business mailing address

10565 CIVIC CENTER DR STE 250
RANCHO CUCAMONGA CA
91730-3854
US

V. Phone/Fax

Practice location:
  • Phone: 424-903-7007
  • Fax:
Mailing address:
  • Phone: 909-493-3800
  • Fax: 626-696-1451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number53052
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: