Provider Demographics
NPI:1578912317
Name:IBRAHIM, ANWAR MICHAEL (DNM, ND, BA PSY, HHP)
Entity Type:Individual
Prefix:DR
First Name:ANWAR
Middle Name:MICHAEL
Last Name:IBRAHIM
Suffix:
Gender:M
Credentials:DNM, ND, BA PSY, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 N WHITNEY AVE
Mailing Address - Street 2:BUSINESS ADDRESS COMING SOON
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3940
Mailing Address - Country:US
Mailing Address - Phone:559-797-8797
Mailing Address - Fax:
Practice Address - Street 1:8635 N WHITNEY AVE
Practice Address - Street 2:BUSINESS ADDRESS COMING SOON
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3940
Practice Address - Country:US
Practice Address - Phone:559-797-8797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No173C00000XOther Service ProvidersReflexologist
No174H00000XOther Service ProvidersHealth Educator
No175L00000XOther Service ProvidersHomeopath