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General NPI Number Information
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NPI Number | 1669352639
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Entity Type | Individual
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Provider Name | JOSEF GEBRE
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Gender | Male
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Dates
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Enumeration Date | 09/02/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 310-773-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 11734 BRADDOCK DR APT 370
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City | CULVER CITY
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State | CA
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Zip | 90230-5162
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Country | US
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Telephone | 310-773-8722
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95036626
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License Number State | CA
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