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General NPI Number Information
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NPI Number | 1154657716
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Entity Type | Individual
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Provider Name | FOAD ELAHI MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 1144 NORMAN DR SUITE 104
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City | MANTECA
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State | CA
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Zip | 95336-5925
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Country | US
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Telephone | 209-824-4400
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Fax | 209-824-4420
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Provider Business Mailing Address
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Address Line | 1144 NORMAN DR SUITE 104
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City | MANTECA
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State | CA
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Zip | 95336-5925
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Country | US
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Telephone | 209-824-4400
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Fax | 209-824-4420
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 25335
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 036126105
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 39467
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 39467
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A106279
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License Number State | CA
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