Active NPI
Fahd Al-Alou, M.D.
- Pediatrics Physician
- Yuma, AZ
National Provider Identifier
1679517858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 45521
- Practice address
- 2435 S Avenue a Ste a
Yuma, AZ 85364-7176 - Phone
- (928) 366-1026
- Fax
- (928) 366-1028
- NPI assigned
- Jun 16, 2006
- Last updated
- Jul 10, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 45521 | AZ | |
| Internal Medicine Physician | 207R00000X | 45521 | AZ | |
| Internal Medicine Physician | 207R00000X | 0407 | MP | |
| Pediatrics Physician | 208000000X | 0407 | MP | |
| Pediatrics Physician | 208000000X | 45521 | AZ | Primary |
Addresses
Primary practice location
2435 S Avenue a Ste a
Yuma, AZ 85364-7176
Mailing address
2435 S Avenue a Ste a
Yuma, AZ 85364-7176
Phone (928) 366-1026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 687617 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45521 | AZ | MD | Pediatrics Physician |
| 0407 | MP | MD | Pediatrics Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1679517858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2435 S AVENUE A STE A",
"city": "YUMA",
"state": "AZ",
"postal_code": "853647176",
"telephone_number": "928-366-1026",
"fax_number": "928-366-1028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2435 S AVENUE A STE A",
"city": "YUMA",
"state": "AZ",
"postal_code": "853647176",
"telephone_number": "928-366-1026",
"fax_number": "928-366-1028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AL-ALOU",
"first_name": "FAHD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-16",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "AZ",
"license": "45521",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "45521",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MP",
"license": "0407",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MP",
"license": "0407",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "45521",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "687617",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.