Jane Abdelhadi, M.D.
Individual provider Active NPI Internal Medicine Physician · Orange, CA
NPI 1124097100 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1124097100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A70158 (CA)
- Practice address
- 1310 W Stewart Dr
Suite 410
Orange, CA 92868-3854 - Phone
- (714) 639-9401
- NPI assigned
- Mar 14, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060202000922 | CA | Practitioner - Geriatric Medicine |
8921012519 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A70158 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088
441 N Lakeview Ave
Anaheim, CA 92807
Phone (714) 279-4000
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A70158 | CA | Yes |
Addresses
Primary practice location
1310 W Stewart Dr
Suite 410
Orange, CA 92868-3854
Mailing address
1310 W Stewart Dr
Suite 410
Orange, CA 92868-3854
Phone (714) 639-9401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912919804 | Other | NPI - TYPE 2 | |
| CG5665 | Other | CA | RAIL ROAD MEDICARE - GROUP PTAN |
| P00284314 | Other | CA | RAIL ROAD MEDICARE - PROVIDER PTAN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Orange, CA
- Abc Medicine Inc
- Abc Medicine Inc
- Alaa Ramadan Abd Allah
- Amr A Abdelaziz
- Anwar Abdelhadi
- Krystal Abdelmeseeh
- Marina Osama Rafat Said Abdelmessih
- Mark Abdelnour
- Jose E. Abdenur
- Yasmin Mokhtar Abdi
All providers in Orange, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.