MEDICARE: BISHOY LABIB M.D.

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
1	2084N0400X	Neurology Physician	A79846	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992723605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BISHOY LABIB M.D.

Provider Business Mailing Address
First Line	:	PO BOX 10239
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92255-0239
Country	:	US
Telephone Number	:	760-779-1177
Fax Number	:	760-779-0099

Provider Business Practice Location Address
First Line	:	72670 FRED WARING DR
Second Line	:	STE 103
City	:	PALM DESERT
State	:	CA
Zip	:	92260-5012
Country	:	US
Telephone Number	:	760-779-1177
Fax Number	:	760-779-0099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/13/2019

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