Waleed Ibrahim M.D., Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A77739 Issued in CA

Legal business name

WALEED IBRAHIM M.D., INC.

Practice address

999 S Fairmont Ave
Ste. 115
Lodi, CA 95240-5100

Phone

(209) 334-7559

Fax

(209) 334-7459

NPI assigned

Jan 28, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Waleed Ibrahim, M.D.

Title

Owner

Phone

(209) 334-7559

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mazen Muhammad Mardini, MD

  • Gastroenterology Physician
  • Lodi, CA
  • NPI 1518909126
  NPD (past)

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1376720813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE",
            "address_2": "STE. 115",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405100",
            "telephone_number": "209-334-7559",
            "fax_number": "209-334-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S FAIRMONT AVE",
            "address_2": "STE. 115",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405100",
            "telephone_number": "209-334-7559",
            "fax_number": "209-334-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALEED IBRAHIM M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "WALEED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-334-7559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A77739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Vong, AU.D.
• Mary Jane Vredenburg, DO
• Joe Y Vuong, PHARM D
• Sania Waheed, RPH
• Cheryl Ann Wakeham, CATC
• Walgreen Co (Walgreens #02961)
• Jennifer Marie Wallmark, CCC-SLP
• Walmart Inc. (Walmart Pharmacy 10-1789)
• Walmart Stores, Inc. (Vision Center 30-1789)
• John Walter, M.D.

• Gastroenterology Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.