Provider Demographics
NPI:1356502116
Name:IBRAHIM-ABDELAZIZ, DALIA (MD)
Entity Type:Individual
Prefix:DR
First Name:DALIA
Middle Name:
Last Name:IBRAHIM-ABDELAZIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DALIA
Other - Middle Name:
Other - Last Name:IBRAHIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14252 CULVER DR # A338
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-0317
Mailing Address - Country:US
Mailing Address - Phone:310-721-7217
Mailing Address - Fax:
Practice Address - Street 1:1310 SAN BERNARDINO RD
Practice Address - Street 2:STE 103
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4979
Practice Address - Country:US
Practice Address - Phone:909-920-0444
Practice Address - Fax:909-920-5044
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA131849207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology