=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750204244
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOHAMMED AL JUBRAN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2026
-----------------------------------------------------
Last Update Date | 08/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9500 EUCLID AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44195-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-444-2200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | EGAC6855
-----------------------------------------------------
City | TARUT
-----------------------------------------------------
State | EASTERN PROVINCE
-----------------------------------------------------
Zip | 32617
-----------------------------------------------------
Country | SA
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2279C0205X
-----------------------------------------------------
Taxonomy Name | Critical Care Registered Respiratory Therapist
-----------------------------------------------------
License Number | RCP.18586
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------