Provider Demographics
NPI:1255401238
Name:IBRAHIM, ALBEER I (MD)
Entity type:Individual
Prefix:DR
First Name:ALBEER
Middle Name:I
Last Name:IBRAHIM
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 1:16260 VENTURA BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2237
Mailing Address - Country:US
Mailing Address - Phone:818-789-7937
Mailing Address - Fax:818-789-7106
Practice Address - Street 1:16260 VENTURA BLVD STE 330
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2237
Practice Address - Country:US
Practice Address - Phone:818-789-7937
Practice Address - Fax:818-789-7106
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44213174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44213Medicare ID - Type Unspecified