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General NPI Number Information
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NPI Number | 1245770155
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Entity Type | Organization
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Legal Business Name | DR NABIL ABUDAYEH
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 20700 LAKE CHABOT RD STE 107
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5401
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Country | US
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Telephone | 510-728-7961
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Fax | 510-886-0268
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Provider Business Mailing Address
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Address Line | 20700 LAKE CHABOT RD STE 107
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-5401
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Country | US
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Telephone | 510-728-7961
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Fax | 510-886-0268
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DOROTHY MARION
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Credential |
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Telephone | 650-771-2814
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | G059072
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License Number State | CA
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