Healthcare Provider Details

I. General information

NPI: 1043282783
Provider Name (Legal Business Name): HADEEL ISSA NAQIB M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S WELLS RD
VENTURA CA
93004-1377
US

IV. Provider business mailing address

200 S WELLS RD
VENTURA CA
93004-1377
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-6434
  • Fax:
Mailing address:
  • Phone: 410-687-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC52879
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0041989
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-039396-Y
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: