Individual
FADY KADIFA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24411 HEALTH CENTER DR, STE 560, LAGUNA HILLS, CA 92653-3651
(949) 452-0061
Mailing address
PO BOX 7630, LAGUNA NIGUEL, CA 92607-7630
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A50822
CA
207RP1001X
Pulmonary Disease Physician
Primary
A50822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A508220
—
CA
01
—
P00229594
MEDICARE RAILROAD
—
Enumeration date
09/20/2006
Last updated
12/20/2012
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