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General NPI Number Information
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NPI Number | 1467883272
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Entity Type | Organization
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Legal Business Name | AHMED ALSADEK, MD INC.
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 17100 EUCLID ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4004
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Country | US
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Telephone | 310-962-0224
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Fax |
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Provider Business Mailing Address
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Address Line | 45 PALATINE # 134
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City | IRVINE
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State | CA
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Zip | 92612-7628
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Country | US
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Telephone | 310-962-0224
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / MEDICAL DOCTOR
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Name | AHMED ALSADEK
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Credential | M.D.
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Telephone | 310-962-0224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A93004
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License Number State | CA
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