Healthcare Provider Details

I. General information

NPI: 1386810158
Provider Name (Legal Business Name): SAAD PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 N 13TH AVE SUITE E
UPLAND CA
91786-4975
US

IV. Provider business mailing address

630 N 13TH AVE SUITE E
UPLAND CA
91786-4975
US

V. Phone/Fax

Practice location:
  • Phone: 909-946-6676
  • Fax: 909-946-7368
Mailing address:
  • Phone: 909-946-6676
  • Fax: 909-946-7368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTOUNE SAAD
Title or Position: PHYSICIAN
Credential: MD
Phone: 909-946-6676