| Habib Ali Ismail, MD | |
|
1330 W Covina Blvd, Ste 103, San Dimas, CA 91773-3200 | |
| (909) 592-2145 | |
| (909) 599-6217 |
| Full Name | Habib Ali Ismail |
|---|---|
| Gender | Male |
| Speciality | Pediatric Medicine |
| Experience | 51 Years |
| Location | 1330 W Covina Blvd, San Dimas, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205893245 | NPI | - | NPPES |
| 00A43523 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | A43523 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| San Antonio Regional Hospital | Upland, CA | Hospital |
| Pomona Valley Hospital Medical Center | Pomona, CA | Hospital |
| Entity Name | Habib A. Ismail, M.d., Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720366677 PECOS PAC ID: 9638343148 Enrollment ID: O20111118000498 |
| Entity Name | Childrens Hospital Of Orange County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275975104 PECOS PAC ID: 6406944883 Enrollment ID: O20181213000428 |
| Mailing Address | Practice Location Address |
|---|---|
| Habib Ali Ismail, MD 1330 W Covina Blvd, Ste 103, San Dimas, CA 91773-3200 Ph: (909) 592-2145 | Habib Ali Ismail, MD 1330 W Covina Blvd, Ste 103, San Dimas, CA 91773-3200 Ph: (909) 592-2145 |
Dr. Divya Krishnamoorthy, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 762 Cypress St, San Dimas, CA 91773 Phone: 909-599-1227 Fax: 206-299-9789 | |
Dr. Hanumantharao Damerla, M.D., Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1900 Sycamore Canyon Rd, San Dimas, CA 91773 Phone: 626-975-2968 Fax: 213-639-1361 | |
Dr. Jia Mao, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 540 E Foothill Blvd Ste 100h, San Dimas, CA 91773 Phone: 626-466-6628 | |
Mohsen Ibrahim Ali, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1330 W Covina Blvd, Suite 103, San Dimas, CA 91773 Phone: 909-592-2145 Fax: 909-599-6217 | |
Joshua Kritsada Koh, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1173 N Dixie Dr, Suite 101, San Dimas, CA 91773 Phone: 909-599-4422 Fax: 909-599-5577 |