Abdo J. Faddoul, M.D. a Prof Corp
Organization Active NPI Urology Physician · Roseville, CA
NPI 1134434764 · NPPES record last updated Aug 6, 2010
Key facts
- NPI
- 1134434764
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- License
- A41062 (CA)
- Legal business name
- ABDO J. FADDOUL, M.D. A PROF CORP
- Practice address
- 2 Medical Plaza
Suite 285
Roseville, CA 95661 - Phone
- (916) 786-3100
- Fax
- (916) 786-9433
- NPI assigned
- Aug 6, 2010
- Organization subpart
- No
Authorized official
- Name
- Mr. Abdo Joseph Faddoul, M.D.
- Title
- President-Owner
- Phone
- (916) 786-3100
National Provider Directory
Locations
2 Medical Plaza Dr
Ste 285
Roseville, CA 95661
Phone (916) 786-3100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | A41062 | CA | Yes |
Addresses
Primary practice location
2 Medical Plaza
Suite 285
Roseville, CA 95661
Mailing address
2 Medical Plaza
Suite 285
Roseville, CA 95661
Phone (916) 786-3100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A416020 | Medicaid | CA |
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All providers in Roseville, CA · Urology 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 Aug 6, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.