NPIMap

Organization Active NPI

Omar O. Fadeel, MD

Doing business as Office of Dr. Omar Fadeel

  • Non-Pharmacy Dispensing Site
  • Anaheim, CA
National Provider Identifier
1740534932
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
A44522 Issued in CA
Legal business name
OMAR O. FADEEL, MD
Doing business as
Office of Dr. Omar Fadeel
Practice address
3356 W Ball Rd
100
Anaheim, CA 92804-3702
Phone
(714) 827-6625
NPI assigned
Nov 9, 2012
Organization subpart
Yes
Parent organization
MEDVANTX, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Kenny Heine
Title
VP Ops
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X A44522 CA Primary

Addresses

Primary practice location

3356 W Ball Rd
100
Anaheim, CA 92804-3702

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Office of Dr. Omar Fadeel Doing business as

National Provider Directory

National Provider Directory
Part of
Tri - State Medical Group Inc

Locations

3356 W Ball Rd
Ste 100
Anaheim, CA 92804
Phone (714) 827-6625

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1740534932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3356 W BALL RD",
            "address_2": "100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043702",
            "telephone_number": "714-827-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAR O. FADEEL, MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OPS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A44522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Office of Dr. Omar Fadeel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.