Individual provider Active NPI

Iman Fawad, M.B.,B.S.

  • Pediatric Cardiology Physician
  • Palo Alto, CA
National Provider Identifier
1063117778
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A208075 Issued in CA
Practice address
750 Welch Rd Ste 305
Palo Alto, CA 94304-1510
Phone
(650) 721-6849
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X A208075 CA Primary

Addresses

Primary practice location

750 Welch Rd Ste 305
Palo Alto, CA 94304-1510

Mailing address

750 Welch Rd Ste 305
Palo Alto, CA 94304-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230612002190 OH Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8921465600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1063117778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WELCH RD STE 305",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELCH RD STE 305",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041510",
            "telephone_number": "650-721-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAWAD",
        "first_name": "IMAN",
        "credential": "M.B.,B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A208075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.