Active NPI
Fahmy Ibrahim MD Inc
- Psychiatry Physician
- Modesto, CA
National Provider Identifier
1811291503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- 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
- Last updated
- Mar 29, 2017
- Organization subpart
- No
NPPES NPI Registry
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
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary | ||
| Child & Adolescent Psychiatry Physician | 2084P0804X |
Addresses
Primary practice location
1501 Claus Road
Modesto, CA 95355
Mailing address
PO Box 576649
Modesto, CA 95357-6649
Phone (209) 571-8330
National Provider Directory
National Provider DirectoryLocations
120 Vantis Dr
Ste 300
Aliso Viejo, CA 92656
Phone (949) 328-6693
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatry Physician
- Modesto, CA
- NPI 1255424404
NPI Registry JSON
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": []
}
Other providers in Modesto, CA
Sources for this page
- 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.