Samuel Ibrahim, MD, Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A120880 Issued in CA

Legal business name

SAMUEL IBRAHIM, MD, INC

Practice address

79180 Corporate Center Dr
Suite 101
La Quinta, CA 92253-7235

Phone

(760) 837-7910

Fax

(760) 837-7920

NPI assigned

Jan 18, 2016

Last updated

Jan 18, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Samuel Ibrahim, MDNPI 1326212358

Title

Owner

Phone

(440) 241-3033

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Assad Amin Ibrahim, M.D.

  • Surgery Physician
  • La Quinta, CA
  • NPI 1326212358

  Neurological Surgery

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453075200000",
    "number": "1184081432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79180 CORPORATE CENTER DR",
            "address_2": "SUITE 101",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537235",
            "telephone_number": "760-837-7910",
            "fax_number": "760-837-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79180 CORPORATE CENTER DR",
            "address_2": "SUITE 101",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922537235",
            "telephone_number": "760-837-7910",
            "fax_number": "760-837-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL IBRAHIM, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-241-3033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A120880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montserrat Salas Flores
• Cristal Salcido Najar, ND, APCC
• Carolina Saldana
• Savannah L Salwey
• Frederick Blabagno Samra, PHARMD
• Gabriel J Sanchez
• Marisa Chaidez Sanchez, NP
• Sanjay Verma, MD a Professional Corporation (Comprehensive Cardiovascular Center of Coachella Valley)
• Yvonne Santana
• Marissa M Sarabia, DNP, RN, CPNP-PC

• Surgery Physician in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.