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General NPI Number Information
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NPI Number | 1275340234
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Entity Type | Individual
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Provider Name | FADYA MIKHAEL
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Gender | Female
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1340 BISON AVE
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-9071
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Country | US
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Telephone | 949-942-1659
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Fax |
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Provider Business Mailing Address
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Address Line | 461 21ST AVE S
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City | NASHVILLE
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State | TN
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Zip | 37240-2455
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95037465
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License Number State | CA
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