Fahmy Ibrahim MD Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

FAHMY IBRAHIM MD INC

Practice address

1501 Claus Road
Modesto, CA 95355

Phone

(209) 557-6300

Fax

(209) 555-7638

NPI assigned

Jan 10, 2011

Organization subpart

No

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

Authorized official

Name

Fahmy Ibrahim, M.D.

Title

Owner

Phone

(718) 300-5714

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1811291503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576649",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576649",
            "telephone_number": "209-571-8330",
            "fax_number": "209-491-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 CLAUS ROAD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-557-6300",
            "fax_number": "209-555-7638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAHMY IBRAHIM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "FAHMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-300-5714",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.