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General NPI Number Information
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NPI Number | 1831471093
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Entity Type | Individual
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Provider Name | HABIB HABIB M.D
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Gender | Male
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 1801 E MARCH LN STE D400
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City | STOCKTON
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State | CA
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Zip | 95210-6675
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Country | US
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Telephone | 209-464-3615
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Fax | 209-464-1537
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Provider Business Mailing Address
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Address Line | 1801 E MARCH LN STE D400
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City | STOCKTON
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State | CA
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Zip | 95210-6675
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Country | US
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Telephone | 209-464-3615
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Fax | 209-464-1537
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD460501
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A154787
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License Number State | CA
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