Provider Demographics
NPI:1982700597
Name:ALEX O HABIBE MD INC
Entity Type:Organization
Organization Name:ALEX O HABIBE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:O
Authorized Official - Last Name:HABIBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-233-4691
Mailing Address - Street 1:1383 E HERNDON AVE
Mailing Address - Street 2:STE 105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3302
Mailing Address - Country:US
Mailing Address - Phone:559-233-4691
Mailing Address - Fax:
Practice Address - Street 1:1383 E HERNDON AVE
Practice Address - Street 2:STE 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3302
Practice Address - Country:US
Practice Address - Phone:559-233-4691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91655261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID #
CA=========OtherTAX ID #