Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306852934 Individual Practitioner Male Practitioner

Dr. Maged Fayez Ibrahim , MD

Pediatrics • Fontana, CA

Professional Overview & Biography Verified Profile Summary

Dr. Maged Ibrahim, MD is a registered healthcare professional specializing in Pediatrics in Fontana, CA. Practice services are available at 16465 SIERRA LAKES PKWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

16465 Sierra Lakes Pkwy

Fontana, CA 923361242

Telephone 9098238000
Fax 9098238088
Associated Practice Facility / Clinic
🏢 Ashapurimaa Inc Facility NPI 1275627671

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Fontana, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 32.0 Yrs
State Avg: 22.5 Yrs
Regional Practice Density
77 Specialists

Practicing in Fontana, CA (9612 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-05-24
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License CA C141296

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License MI 4301076933

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License IN 01071369A

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
201079810 (IN)
Medicaid State Provider ID
4376460 (MI)
Commercial Insurance / Payer ID Bcbs Memorials Childrens Hospital
000000778133 (IN)
Commercial Insurance / Payer ID Bcbs Bmg Main Street
000000781460 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

24 Associated Practitioners
NPI 1013408848

Doctor of Medicine (M.D.)

Lisa Hanson

Nurse Practitioner - Family

NPI 1013676048
Emily Hun , PA-C

Physician Assistant - Medical

NPI 1164605093

Physician Assistant (Certified)

Yareli Renovato , MA

Community Health Worker

NPI 1194604835

Master of Arts

NPI 1265642052

Doctor of Osteopathic Medicine (D.O.)

Lauren Matsumoto , CPNP

Nurse Practitioner - Pediatrics

NPI 1316316946

Certified Pediatric Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
📍
Updated Practice Location May 24, 2022

Registered at 16465 SIERRA LAKES PKWY, FONTANA, CA 923361242 (Tel: 9098238000)

📍
Updated Business Mailing Address May 24, 2022

Registered at 6180 CANTABRIA AVE, RANCHO CUCAMONGA, CA 917376990 (Tel: 6935796092)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 24, 2022

Pediatrics (License #4301076933 in MI)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Pediatrics (License #01071369A in IN)

NPI Profile Active July 25, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location July 25, 2017

Registered at 2933 UNIVERSITY AVE, RIVERSIDE, CA 92507 (Tel: 9515712300)

📍
Updated Business Mailing Address July 25, 2017

Registered at 710 N NILES AVE, SOUTH BEND, IN 466171924 (Tel: (574) 647-1610)

👤
Provider Name / Credentials Updated July 25, 2017

Recorded as MAGED IBRAHIM, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2017

Pediatrics (License #4301076933 in MI)

NPI Profile Active March 17, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location March 17, 2016

Registered at 100 NAVARRE PL, SUITE 4440, SOUTH BEND, IN 466011156 (Tel: 5746474540)

📍
Updated Business Mailing Address March 17, 2016

Registered at 710 N NILES AVE, SOUTH BEND, IN 466171924 (Tel: 5746471610)

👤
Provider Name / Credentials Updated March 17, 2016

Recorded as MAGED IBRAHIM, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2016

Pediatrics (License #01071369A in IN)

🟢
Initial NPI Registration & Enumeration August 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306852934
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 01, 2006
Last Update: May 24, 2022
Sole Proprietor: Yes

Mailing Address

6180 Cantabria Ave

Rancho Cucamonga, CA 917376990

Phone: 6935796092

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.