DR. MAGED FAYEZ IBRAHIM (NPI# 1306852934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306852934 |
| Entity Type | Individual |
| Full Name | DR. MAGED FAYEZ IBRAHIM |
| Credential | M.D. |
| Practice Address |
2933 University Ave Riverside CA 92507 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 9515712300 |
| Mailing Telephone | (574) 647-1610 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | C141296 | CA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 01071369A | IN | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 4301076933 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4376460 | 05 | |
| IN | BCBS MEMORIALS CHILDRENS HOSPITAL | 000000778133 | 01 |
| IN | BCBS BMG MAIN STREET | 000000781460 | 01 |
| IN | 201079810 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 Navarre Pl, Suite 4440, South Bend, IN 466011156 | 5746474540 | 5746474542 |
| Street Address |
2933 UNIVERSITY AVE |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166978 | Michael Lee Hetsko | Dentist | 2933 University Ave, Riverside, CA 92507-4243 | 2005-10-03 |
| 1871084715 | Claudia Jeannethe Cardoza | Social Worker | 2933 University Ave, Riverside, CA 92507 | 2018-05-26 |
| 1952845364 | David Brandt | Nurse Practitioner | 2933 University Ave, Riverside, CA 92507-4243 | 2016-12-05 |
| 1730420399 | Sanjeev Puri | Family Medicine | 2933 University Ave, Riverside, CA 92507-4243 | 2013-03-07 |
| 1205102068 | Community Health Systems, Inc. | Family Medicine | 2933 University Ave, Riverside, CA 92507-4243 | 2012-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448917 | Rachel Nielson | Counselor | 1450 Spruce St, Suite A, Riverside, CA 92507 | 2020-08-24 |
| 1437769742 | Pakravan, Manavi & Cohen Dental Corporation | Dentist | 2862 Unit B Canyon Springs Parkway, Riverside, CA 92507 | 2020-08-03 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1164067567 | Audrey Gruen | Social Worker | Canyon Crest Mental Health, 5225 Canyon Crest Drive #100, Riverside, CA 92507 | 2019-11-10 |
| 1518432962 | Antonio Mixon | Specialist | 1405 Spruce Street, Suite A, Riverside, CA 92507 | 2018-10-11 |
| 1811479793 | New Day Counseling Services | Counselor | 20363 Harvard Way, Riverside, CA 92507 | 2018-09-06 |
| 1780176875 | Miriam Martinez | Case Manager/Care Coordinator | 2085 Rustin Ave., Riverside, CA 92507 | 2018-06-04 |
| 1518478874 | Lisa Manuel | Counselor | 2058 Rustin Ave, Riverside, CA 92507 | 2017-10-13 |
| 1497272942 | Yajaira Placensia | Behavioral Analyst | 1486 Everton Place, Riverside, CA 92507 | 2017-08-25 |
| 1841717691 | Stephanie Teuchert | Behavioral Analyst | 1080 Spruce Street Apartment 7c, Riverside, CA 92507 | 2017-08-23 |
| Find all providers in zip 92507 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710590971 | Javier R Rios Md, A Professional Corporation | Pediatrics | 6926 Brockton Ave Ste 4&7, Riverside, CA 92506-3800 | 2020-08-27 |
| 1295187003 | Sharon L. Bivins, M.d. | Pediatrics | 16743 Orville Wright Dr, Riverside, CA 92518-2928 | 2016-07-05 |
| 1831540715 | Hilary Christina Hoffmeister | Pediatrics | 41 Jones Park Dr, Riverside, CT 06878-2205 | 2016-06-22 |
| 1023453081 | Stacy Marie Catalon | Pediatrics | 19314 Jesse Ln, Riverside, CA 92508-5069 | 2013-05-05 |
| 1588935233 | Joseph M Molina Md Professional Corporation-southern California | Pediatrics | 5549 Van Buren Blvd., Riverside, CA 92503-2068 | 2012-01-25 |
| 1497049126 | Nancy Nejman Fazzinga I | Pediatrics | 10 Newton St, Riverside, CT 06878-2010 | 2011-05-28 |
| 1457597247 | Natasha Denise White | Pediatrics | 1744 University Ave Ste 100, Riverside, CA 92507-5364 | 2008-12-28 |
| 1285887653 | Jennifer Elaine Rousseau | Pediatrics | 9041 Magnolia Ave Ste 305, Riverside, CA 92503-3957 | 2008-10-29 |
| 1063672160 | Beth Joy Rosenberg | Pediatrics | 1171 E Putnam Ave Ste 2b, Riverside, CT 06878-1426 | 2008-06-11 |
| 1639378748 | Adwoa P Osei | Pediatrics | Ucr Health Multispecialty, 3390 University Ave., Ste., 100, Riverside, CA 92501 | 2007-07-17 |
| Find all providers in RIVERSIDE | ||||
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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.