Doctor Name: | HABIB ALI ISMAIL |
NPI Number: | 1205893245 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A43523 |
Business Practice Address: | 1330 W Covina Blvd Ste 103 San Dimas, CA - 917733200 |
Business Phone Number: | 9095922145 |
Business Fax Number: | 9095996217 |
Mailing Address: | 1330 W Covina Blvd, Ste 103 SAN DIMAS |
State: | CA |
Postal Code: | 917733200 |
Phone Number: | 9095922145 |
Fax Number: | 9095996217 |
NPI Enumeration Date: | 04/26/2006 |
NPI Last Update Date: | 11/05/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084N0402X |
License Number: | A43523 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Neurology with Special Qualifications in Child Neurology |
Taxonomy Definition: | A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |