MEDICARE: DR. FUAD GHANEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP3000X	Pediatric Anesthesiology Physician	SPI928	CA

General Provider Information

NPI Number	:	1750251260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FUAD GHANEM

Provider Business Mailing Address
First Line	:	1975 4TH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2351
Country	:	US
Telephone Number	:	415-476-9035
Fax Number	:	415-353-9163

Provider Business Practice Location Address
First Line	:	1975 4TH ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2351
Country	:	US
Telephone Number	:	415-476-9035
Fax Number	:	415-353-9163

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	12/02/2025

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Directions to “ DR. FUAD GHANEM ” Practice Location

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