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General NPI Number Information
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NPI Number | 1326377136
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Entity Type | Organization
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Legal Business Name | LAMAR REGIONAL HEALTH CENTER
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 3090 INDEPENDENCE DR SUITE 112
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City | LIVERMORE
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State | CA
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Zip | 94551-9493
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Country | US
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Telephone | 925-297-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 11490 BURBANK BLVD STE 3H
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2389
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERNEST R JABOUR
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Credential | MD
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Telephone | 925-297-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G87945
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License Number State | CA
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