EMAD IBRAHIM, MD, INC. (NPI# 1114371481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114371481 |
| Entity Type | Organization |
| Organization Name | EMAD IBRAHIM, MD, INC. |
| Practice Address |
255 Terracina Blvd Suite 104b Redlands CA 92373-4870 |
| Mailing Address |
527 Acacia Ct Redlands CA 92373-5667 |
| Practice Telephone | 9097934336 |
| Practice Fax Number | 9097933325 |
| Mailing Telephone | 9095573983 |
| Mailing Fax Number | 9093356162 |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-04-22 |
| Authorized Official Name | EMAD IBRAHIM (OWNER) |
| Authorized Official Telephone | 9095573983 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
A51062 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A510620 | 05 |
| Street Address |
255 TERRACINA BLVD SUITE 104B |
| City | REDLANDS |
| State | CA |
| Zip Code | 92373-4870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386643534 | Sharen Knudsen Jeffries | Otolaryngology | 255 Terracina Blvd, Suite 201, Redlands, CA 92373-4870 | 2005-07-19 |
| 1356840300 | April Zainea | Nurse Practitioner | 255 Terracina Blvd, Suite 205a, Redlands, CA 92373 | 2018-02-06 |
| 1720586175 | Ruben I Robles | Marriage & Family Therapist | 255 Terracina Blvd, Suite 204, Redlands, CA 92373 | 2018-01-30 |
| 1043766827 | Denette Wilson | Social Worker | 255 Terracina Blvd, Suite 204, Redlands, CA 92373-4870 | 2016-08-31 |
| 1831549906 | Taylor D Todd | Physician Assistant | 255 Terracina Blvd, Suite 205c, Redlands, CA 92373-4870 | 2016-06-20 |
| 1134509177 | Christina Ruiz | Nurse Practitioner | 255 Terracina Blvd, Suite 205a, Redlands, CA 92373-4870 | 2015-06-04 |
| 1699177550 | Jeannette Langston | Nurse Practitioner | 255 Terracina Blvd, Redlands, CA 92373-4870 | 2014-09-23 |
| 1578803029 | Jesus Quirarte | Registered Nurse | 255 Terracina Blvd, Redlands, CA 92373-4870 | 2013-02-20 |
| 1306194261 | Soeprono Medical Corporation | Clinical Medical Laboratory | 255 Terracina Blvd, Ste 206, Redlands, CA 92373-4870 | 2012-08-27 |
| 1255688032 | Javier Martin Panameno Campos | Social Worker | 255 Terracina Blvd, Suite 204, Redlands, CA 92373-4870 | 2012-08-10 |
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|---|---|---|---|---|
| 1508473422 | Mindfulness Counseling Services | Marriage & Family Therapist | 101 E. Redlands, Suite 170a, Redlands, CA 92373 | 2020-09-24 |
| 1710596721 | Vandna Mittal | Counselor | 26967 Beamount Avenue, 1020 Coronado Drive, Redlands, CA 92373 | 2020-07-26 |
| 1164062345 | Sara Bencoe | Nurse Practitioner | 101 E. Redlands Blvd. Ste. 106, Redlands, CA 92373 | 2020-01-15 |
| 1033604103 | John Duane Wuchenich | Anesthesiology | 451 Summit Avenue, Redlands, CA 92373 | 2018-06-29 |
| 1013401074 | Adept Hospice Care | Hospice Care, Community Based | 515 New Jersey St., Suite G, Redlands, CA 92373 | 2018-06-21 |
| 1134616121 | Rodrigo Robles | Student in an Organized Health Care Education/Training Program | 26001 Redlands Blvd ., 2nd Floor, 2d 301, Redlands, CA 92373 | 2018-04-16 |
| 1760987614 | Redlands Endodontics | Dentist | 245 Terracina Blvd Suite 207 B, Redlands, CA 92373 | 2018-03-23 |
| 1487164166 | Tyler Stafford | Behavioral Analyst | 1467 Ford St. Suite 104, Redlands, CA 92373 | 2017-10-06 |
| 1083131486 | Shannon Palmowski | Behavioral Analyst | Institute for Behavioral Health, 1041 Alabama Ave, Redlands, CA 92373 | 2017-08-25 |
| 1275062622 | Erim Sarbuland | Marriage & Family Therapist | 101 East Redlands Boulevard, Suites #215, Redlands, CA 92373 | 2017-06-08 |
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| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
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| 1477603983 | Epeius Biotechnologies Corporation | Clinic/Center | 475 Huntington Dr, San Marino, CA 91108-2358 | 2007-01-10 |
| 1063486025 | Sequoia Oncology Medical Assoc | Clinic/Center | 857 Garner Ave, Hanford, CA 93230 | 2006-02-15 |
| 1265405328 | Sequoia Oncology Medical Assoc | Clinic/Center | 4945 W Cypress Ave, Ste C, Visalia, CA 93277 | 2006-02-09 |
| 1164077566 | Vaginal and Pelvic Surgeons, Inc | Clinic/Center | 1325 E Church St, Santa Maria, CA 93454-5909 | 2019-08-03 |
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| 1356848584 | Colton Health LLC | Clinic/Center | 480 Fourth Ave Ste 409, Chula Vista, CA 91910-4413 | 2018-04-13 |
| 1326566431 | Regents Univ of Calif of Los Angeles | Clinic/Center | 200 Medical Plaza Suite 120, Los Angeles, CA 90095-0001 | 2017-09-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.