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General NPI Number Information
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NPI Number | 1275974552
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Entity Type | Individual
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Provider Name | FADI HADDAD D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 147 N BRENT ST
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City | VENTURA
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State | CA
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Zip | 93003-2854
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Country | US
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Telephone | 562-883-8804
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Fax | 805-830-0491
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Provider Business Mailing Address
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Address Line | 383 WALNUT DR
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City | VENTURA
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State | CA
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Zip | 93003-2047
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Country | US
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Telephone | 562-883-8804
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Fax | 805-830-0491
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 20A15567
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License Number State | CA
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