Provider Demographics
NPI:1649284670
Name:GIRGIS, GEORGE IBRAHIM (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:IBRAHIM
Last Name:GIRGIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14004 FREMANTLE CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-9298
Mailing Address - Country:US
Mailing Address - Phone:661-589-6661
Mailing Address - Fax:661-637-1112
Practice Address - Street 1:14004 FREMANTLE CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-9298
Practice Address - Country:US
Practice Address - Phone:661-589-6661
Practice Address - Fax:661-637-1112
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43715208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice