Individual provider Active NPI

Farhan Fadoo, M. D.

  • General Practice Physician
  • French Camp, CA
National Provider Identifier
1093850786
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A93772 Issued in CA
Practice address
500 W Hospital Rd
French Camp, CA 95231-9693
Phone
(209) 468-6820
Fax
(209) 468-7162
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A93772 CA Primary

Addresses

Primary practice location

500 W Hospital Rd
French Camp, CA 95231-9693

Mailing address

500 W Hospital Rd
French Camp, CA 95231-9693
Phone (209) 468-6937

Other identifiers 1

IdentifierTypeStateIssuer
A93772OtherCAMEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address FARHANFADOO@sjgh.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20101216000598 CA Practitioner - Family Practice 9335337401 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A93772CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Faculty Medical Group CurrentSince May 21, 2011 Accepting new patients
County of San Joaquin CurrentSince May 21, 2011 Accepting new patients
County of San Joaquin CurrentSince May 21, 2011 Accepting new patients
Community Medical Centers Inc Past Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: farhanfadoo@sjgh.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marin Community ClinicsNovato, CA, CCN 551918 Federally qualified health center Corporate Officer Dec 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1093850786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W HOSPITAL RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319693",
            "telephone_number": "209-468-6937",
            "fax_number": "209-468-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W HOSPITAL RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319693",
            "telephone_number": "209-468-6820",
            "fax_number": "209-468-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADOO",
        "first_name": "FARHAN",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A93772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A93772",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "FARHANFADOO@sjgh.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "SAN JOAQUIN GENERAL HOSPITAL DIRECT EMAIL ADDRESS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "500 W Hospital Rd",
            "city": "French Camp",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952319693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in French Camp, CA

Sources for this page

Verify at the official NPI Registry.