Organization · NPI-2

Fadi A. Haddad, M.D., INC.

Clinic/Center · La Mesa, CA

NPI number1053590349
StatusActive
Last updated in NPPESDec 16, 2021

Details

NPI
1053590349
Entity type
Organization (NPI-2)
Legal business name
Fadi A. Haddad, M.D., INC.
Organization subpart
No
Enumeration date
Nov 2, 2007
Certification date
Dec 16, 2021
Last updated
Dec 16, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

8860 Center Dr Ste 320
La Mesa, CA 91942-7001

Phone 619-376-1904 · Fax 619-376-1909

Mailing address

8860 Center Dr Ste 320
La Mesa, CA 91942-7001

Phone 619-376-1904 · Fax 619-376-1909

Authorized official

Fadi A. Haddad
President
6193761904

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