Healthcare Provider Details

I. General information

NPI: 1831900257
Provider Name (Legal Business Name): RAFID A H FADUL M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 J ST STE 1550
SACRAMENTO CA
95814-2976
US

IV. Provider business mailing address

548 MARKET ST # 31758
SAN FRANCISCO CA
94104-5401
US

V. Phone/Fax

Practice location:
  • Phone: 877-897-6320
  • Fax:
Mailing address:
  • Phone: 877-897-6320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFID FADUL
Title or Position: PC OWNER
Credential: MD
Phone: 202-557-5361