Michael Mamdouh Aziz Ibrahim

Primary specialty

PharmacistTaxonomy code 183500000X

License

63426 Issued in CA

Practice address

34420 Yucaipa Blvd
Yucaipa, CA 92399-2412

Phone

(909) 797-1312

Fax

(909) 797-3158

NPI assigned

Jul 14, 2010

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)

Not enrolled

Practice roles

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

• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)
• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Yucaipa, CA
  • NPI 1578672093
  NPD (past)

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1811200215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 BARTON RD APT 2713",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735443",
            "telephone_number": "909-797-1312",
            "fax_number": "909-797-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34420 YUCAIPA BLVD",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992412",
            "telephone_number": "909-797-1312",
            "fax_number": "909-797-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MICHAEL",
        "middle_name": "MAMDOUH AZIZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "63426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Hughes
• Susan Hunt
• Huston Psychological Services
• Ronald George Huston, LCP,LCSW,MFT
• Artharee Edward Hutchins IV
• Imago Dei Collective Inc
• Imago Dei Collective Inc
• Kimberleigh Marie Ingram, PHARM D
• Inland Empire Lung and Sleep Institute
• Inland Leaders Charter School

• Pharmacist in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.