Individual
JOSEPH AWADALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(909) 335-6443
(909) 335-5689
Mailing address
PO BOX 295, REDLANDS, CA 92373-0101
(909) 335-6443
(909) 335-5689
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
A047833
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G458000
—
CA
Enumeration date
06/06/2007
Last updated
07/09/2007
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