Healthcare Provider Details

I. General information

NPI: 1730490053
Provider Name (Legal Business Name): EMAN H ALBADDAWI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMAN ALBADDAWI M.D

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 SAINT DOMINICS DR STE 201
MANTECA CA
95337-7802
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 209-830-4062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberC171060
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: