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General NPI Number Information
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NPI Number | 1306295787
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Entity Type | Organization
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Legal Business Name | NABEEL MADANAT M.D. INC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 1828 EL CAMINO REAL STE 701
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City | BURLINGAME
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State | CA
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Zip | 94010-3122
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Country | US
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Telephone | 650-652-9022
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Fax | 650-652-9029
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Provider Business Mailing Address
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Address Line | 1828 EL CAMINO REAL STE 701
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City | BURLINGAME
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State | CA
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Zip | 94010-3122
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Country | US
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Telephone | 650-652-9022
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Fax | 650-652-9029
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Authorized Official
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Title or Position | OWNER
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Name | NABEEL JAMEEL MADANAT
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Credential | M.D.
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Telephone | 650-652-9022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A50176
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | A50176
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License Number State | CA
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