| Habib A. Ismail, M.d., Inc. | |
|
1330 W Covina Blvd Suite 103 San Dimas CA 91773-3200 | |
| (626) 914-2831 | |
| (909) 599-6217 |
| Full Name | Habib A. Ismail, M.d., Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1330 W Covina Blvd, San Dimas, California |
| Authorized Official Name and Position | Habib A. Ismail (OWNER) |
| Authorized Official Contact | 6269142831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Habib A. Ismail, M.d., Inc. 1330 W Covina Blvd Suite 103 San Dimas CA 91773-3200 Ph: (626) 914-2831 | Habib A. Ismail, M.d., Inc. 1330 W Covina Blvd Suite 103 San Dimas CA 91773-3200 Ph: (626) 914-2831 |
| NPI Number | 1720366677 |
|---|---|
| Provider Enumeration Date | 07/26/2011 |
| Last Update Date | 07/26/2011 |
| Medicare PECOS PAC ID | 9638343148 |
|---|---|
| Medicare Enrollment ID | O20111118000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720366677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | A43523 (California) | Primary |
| Provider Name | Habib A Ismail |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205893245 PECOS PAC ID: 9032160346 Enrollment ID: I20050203000732 |
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