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NPI Code Detail

MEDICARE: ERINY ALPHONSE IBRAHIM

MEDICARE: ERINY ALPHONSE IBRAHIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist29987CA

General Provider Information

NPI Number : 1194933416
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERINY ALPHONSE IBRAHIM
Provider Business Mailing Address
First Line : 19736 CRYSTAL HILLS DR
Second Line :
City : NORTHRIDGE
State : CA
Zip : 91326-3846
Country : US
Telephone Number : 818-363-9630
Fax Number :
Provider Business Practice Location Address
First Line : 8250 WOODMAN AVE
Second Line :
City : PANORAMA CITY
State : CA
Zip : 91402-5427
Country : US
Telephone Number : 818-375-4023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 11/30/2021

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Directions to “ ERINY ALPHONSE IBRAHIM ” Practice Location

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