Dr Maged Fayez Ibrahim, MD | |
16465 Sierra Lakes Pkwy, Fontana, CA 92336-1242 | |
(909) 823-8000 | |
(909) 823-8088 |
Full Name | Dr Maged Fayez Ibrahim |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 16465 Sierra Lakes Pkwy, Fontana, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306852934 | NPI | - | NPPES |
000000778133 | Other | IN | BCBS MEMORIALS CHILDRENS HOSPITAL |
000000781460 | Other | IN | BCBS BMG MAIN STREET |
201079810 | Medicaid | IN | |
4376460 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 4301076933 (Michigan) | Secondary |
208000000X | Pediatrics | 01071369A (Indiana) | Secondary |
208000000X | Pediatrics | C141296 (California) | Primary |
Entity Name | Borrego Community Health Foundation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134144165 PECOS PAC ID: 1759299944 Enrollment ID: O20040122000961 |
Mailing Address | Practice Location Address |
---|---|
Dr Maged Fayez Ibrahim, MD 6180 Cantabria Ave, Rancho Cucamonga, CA 91737-6990 Ph: (693) 579-6092 | Dr Maged Fayez Ibrahim, MD 16465 Sierra Lakes Pkwy, Fontana, CA 92336-1242 Ph: (909) 823-8000 |
Mr. James David Killeen Iii, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Kaiser Permanente Fontana - Pediatrics, Fontana, CA 92335 Phone: 909-427-6960 | |
Ramandeep Kaur, M.D Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Pkwy Ste 115, Fontana, CA 92336 Phone: 909-823-8000 Fax: 909-823-8088 | |
Leslie Sison Aquino-peralta, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Connie Lew Cheng, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Miss Irene H Odom, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-5451 | |
Mrs. Emma Claire Boda, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 16465 Sierra Lakes Pkwy Ste 115, Fontana, CA 92336 Phone: 909-823-8000 Fax: 909-823-8088 | |
Eric Mun-kong Wong, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |