Tobi Taofik Ibraheem, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT307364 Issued in CA

Practice address

1294 W 6TH St Ste 101
San Pedro, CA 90731-2997

Phone

(310) 547-1850

Fax

(310) 547-1972

NPI assigned

Dec 16, 2024

Last updated

Dec 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Harbor Physical Therapy & Sports Medical

  • Orthopedic Physical Therapist
  • San Pedro, CA
  • NPI 1255349676
  NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1255148904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST STE 101",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312997",
            "telephone_number": "310-547-1850",
            "fax_number": "310-547-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST STE 101",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312997",
            "telephone_number": "310-547-1850",
            "fax_number": "310-547-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHEEM",
        "first_name": "TOBI",
        "middle_name": "TAOFIK",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "PT307364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huong-Anh Ngo Long, M.D., Inc.
• Andrew Hutcherson
• Tiffany Marie Hutcherson
• Timothy James Hutson, MCA
• Thomas Hyatt
• Uduak Regina Iluore, MD
• Marc Steven Imai, D.D.S.
• Integration Corporation
• Lorraine Rose Iocolano, LMFT
• Marion Christine Ipenburg, LAC, RPT

• Physical Medicine & Rehabilitation Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.