W. Al-Fadly, M.D., Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A20545 Issued in CA

Legal business name

W. AL-FADLY, M.D., INC

Practice address

16000 S Vermont Ave
Gardena, CA 90247-4552

Phone

(310) 324-1183

Fax

(310) 324-4358

NPI assigned

Jul 27, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Waleed S Al-Fadly, M.D.

Title

President

Phone

(310) 324-1183

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1134475171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 S VERMONT AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474552",
            "telephone_number": "310-324-1183",
            "fax_number": "310-324-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 S VERMONT AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474552",
            "telephone_number": "310-324-1183",
            "fax_number": "310-324-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. AL-FADLY, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "AL-FADLY",
        "authorized_official_first_name": "WALEED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-324-1183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A20545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A205453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Vu
• Nina Vu, PHARM. D.
• Kalotia F Vunileva
• Karen Kim Vuong, FNP-C
• Vinh Vuong, PHARM.D.
• Konomi Wada
• Darrius L Wade
• Amanda Wagenbach, LCSW
• Jerry Stanley Wake, O.D.
• Layne Seichi Wakuta

• Primary Care Clinic/Center in Gardena, CA
• Providers in Gardena, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.