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General NPI Number Information
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NPI Number | 1053590349
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Entity Type | Organization
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Legal Business Name | FADI A. HADDAD, M.D., INC.
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 8860 CENTER DR STE 320
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City | LA MESA
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State | CA
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Zip | 91942-7001
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Country | US
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Telephone | 619-376-1904
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Fax | 619-376-1909
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Provider Business Mailing Address
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Address Line | 8860 CENTER DR STE 320
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City | LA MESA
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State | CA
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Zip | 91942-7001
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Country | US
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Telephone | 619-376-1904
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Fax | 619-376-1909
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FADI A. HADDAD
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Credential | M.D.
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Telephone | 619-376-1904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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