Healthcare Provider Details

I. General information

NPI: 1073544722
Provider Name (Legal Business Name): MAHA NAJEEB HADDAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 STOCKTON BLVD UC DAVIS MEDICAL CENTER, DEPARTMENT OF PEDIATRICS
SACRAMENTO CA
95817-2208
US

IV. Provider business mailing address

2850 GRASSLANDS DR APT 2022
SACRAMENTO CA
95833-3532
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-8118
  • Fax: 916-734-0629
Mailing address:
  • Phone: 916-564-4989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberA91988
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: