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General NPI Number Information
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NPI Number | 1407183593
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Entity Type | Organization
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Legal Business Name | EL HADI MOUDERRES MD INC
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Dates
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Enumeration Date | 11/10/2009
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 9727 ELK GROVE FLORIN RD SUITE 120
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City | ELK GROVE
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State | CA
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Zip | 95624-2291
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Country | US
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Telephone | 916-236-3058
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Fax | 916-236-3061
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Provider Business Mailing Address
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Address Line | 9727 ELK GROVE FLORIN RD SUITE 120
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City | ELK GROVE
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State | CA
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Zip | 95624-2291
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Country | US
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Telephone | 916-236-3058
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Fax | 916-236-3061
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. EL HADI MOUDERRES
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Credential | MD
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Telephone | 916-236-3058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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