Provider Demographics
NPI:1154380301
Name:JABOUR, ADEL F (MD)
Entity type:Individual
Prefix:DR
First Name:ADEL
Middle Name:F
Last Name:JABOUR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18350 ROSCOE BLVD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4109
Mailing Address - Country:US
Mailing Address - Phone:818-885-7905
Mailing Address - Fax:818-885-1631
Practice Address - Street 1:18350 ROSCOE BLVD
Practice Address - Street 2:SUITE #200
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4109
Practice Address - Country:US
Practice Address - Phone:818-885-7905
Practice Address - Fax:818-885-1631
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2018-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA304292086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A304290Medicaid
CAA30429Medicare ID - Type UnspecifiedLICENSE
CA00A304290Medicaid