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General NPI Number Information
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NPI Number | 1497736938
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Entity Type | Individual
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Provider Name | JABIR RAHMAN SHARIF M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 4632 W CENTURY BLVD STE A
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City | INGLEWOOD
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State | CA
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Zip | 90304-1454
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Country | US
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Telephone | 310-419-4616
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Fax | 310-419-4756
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Provider Business Mailing Address
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Address Line | 1131 VIA SEBASTIAN
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City | SAN PEDRO
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State | CA
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Zip | 90732-2310
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Country | US
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Telephone | 310-419-4616
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | G53277
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License Number State | CA
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