Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 273273 | NY |
NPI | 1174793814 |
---|---|
Provider Name | Dr. Feraas Jabi |
First Address | Los Angeles, CA 90017-3902 |
Second Address | Los Angeles, CA 90017-3902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 14/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03795680 | (05) | NY |
C168191 | MEDICAL BOARD OF CALIFORNIA (01) | CA |