Healthcare Provider Details

I. General information

NPI: 1922264845
Provider Name (Legal Business Name): HUSSEIN ABDULHADI, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6645 ALVARADO RD SUITE 253
SAN DIEGO CA
92120-5208
US

IV. Provider business mailing address

6645 ALVARADO RD SUITE 253
SAN DIEGO CA
92120-5208
US

V. Phone/Fax

Practice location:
  • Phone: 619-326-0326
  • Fax:
Mailing address:
  • Phone: 619-326-0326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA61032
License Number StateCA

VIII. Authorized Official

Name: RENA FOX
Title or Position: BILLER
Credential:
Phone: 503-245-5970