NPIMap

Individual provider Active NPI

Isaac A Ibrahimi, PA-C

  • Physician Assistant
  • Castro Valley, CA
National Provider Identifier
1588735849
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18248 Issued in CA
Practice address
19850 Lake Chabot Rd
Castro Valley, CA 94546-4002
Phone
(510) 582-8555
Fax
(510) 581-8686
NPI assigned
Nov 10, 2006
Last updated
Jul 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18248 CA Primary

Addresses

Primary practice location

19850 Lake Chabot Rd
Castro Valley, CA 94546-4002

Mailing address

PO Box 11101
Westminster, CA 92685-1101
Phone (866) 878-5075

Other identifiers 2

IdentifierTypeStateIssuer
PA18248OtherCALICENSE
PA18248MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071116000155 CA Practitioner - Physician Assistant 0547358012 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18248CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Jan 31, 2021 Accepting new patients
Alameda Health System CurrentSince Jan 31, 2021 Accepting new patients
Southern Solano Emergency Medical Group, Inc Physician Assistant Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients

Locations

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1588735849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11101",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926851101",
            "telephone_number": "866-878-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19850 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945464002",
            "telephone_number": "510-582-8555",
            "fax_number": "510-581-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIMI",
        "first_name": "ISAAC",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA18248",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA18248",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

Verify at the official NPI Registry.