Healthcare Provider Details

I. General information

NPI: 1467437905
Provider Name (Legal Business Name): PAMELA EVA FADUL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 CITRACADO PKWY
ESCONDIDO CA
92029-4159
US

IV. Provider business mailing address

10554 ASPEN GLN
ESCONDIDO CA
92026-7324
US

V. Phone/Fax

Practice location:
  • Phone: 760-739-3000
  • Fax:
Mailing address:
  • Phone: 760-877-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG86948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: