Provider Demographics
NPI:1528267010
Name:BELABIN, JEFFREY HOWARD (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:HOWARD
Last Name:BELABIN
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21081 S WESTERN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1707
Mailing Address - Country:US
Mailing Address - Phone:107-823-3333
Mailing Address - Fax:
Practice Address - Street 1:21081 S WESTERN AVE STE 150
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1707
Practice Address - Country:US
Practice Address - Phone:107-823-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9010384202D00000X
FL9101384363A00000X
CA53052363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8101953Medicaid
NC8101953Medicaid
NCNC6287KMedicare PIN
NCNC6287PMedicare PIN
NCNC6287DMedicare PIN
NENC6287FMedicare PIN
NCNC6287HMedicare PIN
NCNC6287EMedicare PIN
NCNC6287LMedicare PIN
NCNC6287GMedicare PIN
NCNC6287JMedicare PIN
NCNC6287MMedicare PIN
NCNC6287NMedicare PIN
NCNC6287BMedicare PIN
NCNC6287AMedicare PIN