Provider Demographics
NPI:1043497472
Name:JABEEN, MOBASHSHERA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:MOBASHSHERA
Middle Name:
Last Name:JABEEN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 257TH ST
Mailing Address - Street 2:APT.#3
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2753
Mailing Address - Country:US
Mailing Address - Phone:562-634-1000
Mailing Address - Fax:
Practice Address - Street 1:15730 PARAMOUNT BLVD
Practice Address - Street 2:CONSULTARIO MEDICO LATINO MEDICAL CENTER
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-4333
Practice Address - Country:US
Practice Address - Phone:562-634-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19427363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical