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General NPI Number Information
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NPI Number | 1982626537
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Entity Type | Individual
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Provider Name | FADI GEORGE HADDAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5201 DEER VALLEY RD STE 1E
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City | ANTIOCH
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State | CA
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Zip | 94531-7430
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Country | US
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Telephone | 925-350-8855
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Fax | 925-350-8860
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Provider Business Mailing Address
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Address Line | 8275 ROYALL OAKS DR
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City | GRANITE BAY
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State | CA
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Zip | 95746-9340
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Country | US
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Telephone | 510-813-4747
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Fax | 877-992-2989
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | K4448
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | C51575
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License Number State | CA
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