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General NPI Number Information
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NPI Number | 1811185804
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Entity Type | Organization
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Legal Business Name | EMAD TADROS MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 4060 FOURTH AVE STE 102
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City | SAN DIEGO
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State | CA
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Zip | 92103-2120
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Country | US
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Telephone | 619-692-8118
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Fax | 619-800-7385
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Provider Business Mailing Address
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Address Line | 4060 FOURTH AVE STE 102
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City | SAN DIEGO
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State | CA
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Zip | 92103-2120
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Country | US
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Telephone | 619-692-8118
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Fax | 619-800-7385
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. EMAD G TADROS MD A PROF CORP
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Credential | MD
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Telephone | 619-692-8118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A49500
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License Number State | CA
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