Provider Demographics
NPI:1174793814
Name:JABI, FERAAS (MD)
Entity type:Individual
Prefix:DR
First Name:FERAAS
Middle Name:
Last Name:JABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 WILSHIRE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3902
Mailing Address - Country:US
Mailing Address - Phone:248-462-2992
Mailing Address - Fax:
Practice Address - Street 1:1127 WILSHIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3902
Practice Address - Country:US
Practice Address - Phone:248-462-2992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273273207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC168191OtherMEDICAL BOARD OF CALIFORNIA
NY03795680Medicaid