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General NPI Number Information
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NPI Number | 1043453814
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Entity Type | Individual
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Provider Name | NEDAA N ISSA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 1901 W KETTLEMAN LN STE 200
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City | LODI
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State | CA
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Zip | 95242-4337
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Country | US
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Telephone | 209-334-8540
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Fax | 209-368-2885
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Provider Business Mailing Address
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Address Line | 1901 W KETTLEMAN LN STE 200
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City | LODI
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State | CA
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Zip | 95242-4337
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Country | US
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Telephone | 209-334-8540
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Fax | 209-368-2885
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 24915
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 152298
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License Number State | CA
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