MEDICARE: DR. RICHARD KAY HADA D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	58500	CA

General Provider Information

NPI Number	:	1770715229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD KAY HADA D.M.D.

Provider Business Mailing Address
First Line	:	521 E ELDER ST STE 203
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-3083
Country	:	US
Telephone Number	:	760-728-1592
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 E ELDER ST STE 203
Second Line	:
City	:	FALLBROOK
State	:	CA
Zip	:	92028-3083
Country	:	US
Telephone Number	:	760-728-1592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2009
Last Update Date	:	08/18/2009

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