Provider Demographics
NPI:1447365812
Name:HIRBAWI, IBRIHIM A (MD)
Entity type:Individual
Prefix:
First Name:IBRIHIM
Middle Name:A
Last Name:HIRBAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8073
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-8073
Mailing Address - Country:US
Mailing Address - Phone:949-760-3025
Mailing Address - Fax:949-720-3944
Practice Address - Street 1:1605 AVOCADO
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:949-760-3025
Practice Address - Fax:949-720-3944
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG804902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H00213Medicare UPIN