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General NPI Number Information
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NPI Number | 1518411214
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Entity Type | Organization
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Legal Business Name | FEMAH INC A CALIFORNIA CORPORATION
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 605 S ATLANTIC BLVD
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City | MONTEREY PARK
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State | CA
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Zip | 91754-3817
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Country | US
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Telephone | 626-284-1736
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Fax | 626-310-8304
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Provider Business Mailing Address
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Address Line | 605 S ATLANTIC BLVD
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City | MONTEREY PARK
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State | CA
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Zip | 91754-3817
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Country | US
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Telephone | 626-284-1736
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Fax | 626-310-8304
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | FERNANDO IBARRA
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Credential | MD
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Telephone | 626-284-1736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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