=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952685604
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALBEER IBRAHIM, M.D. INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2011
-----------------------------------------------------
Last Update Date | 09/29/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16260 VENTURA BLVD SUITE 330
-----------------------------------------------------
City | ENCINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91436-2203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-789-7937
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16260 VENTURA BLVD. SUITE 330
-----------------------------------------------------
City | ENCIINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 19436-2203
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-789-7937
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ALBEER IBRAHIM
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 818-789-7937
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 173000000X
-----------------------------------------------------
Taxonomy Name | Legal Medicine
-----------------------------------------------------
License Number | A44213
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------