Physician Compare National (NPI:1598706129)

HEALTHCARE PROVIDER: EMAD N. IBRAHIM MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1598706129
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2062574874
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090102000141
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	IBRAHIM
	Individual professional last name
Provider First Name	EMAD
	Individual professional first name
Provider Middle Name	N
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	HEMATOLOGY/ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	MEDICAL ONCOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	MEDICAL ONCOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	255 TERRACINA BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 104B
	Group Practice or individual's line 2 address
City	REDLANDS
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	923734870
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050272
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	REDLANDS COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050327
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LOMA LINDA UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y