Individual
DR. ALI HADADZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4560 ADMIRALTY WAY STE 303, MARINA DEL REY, CA 90292-5426
(310) 204-5510
(424) 384-5053
Mailing address
4560 ADMIRALTY WAY STE 303, MARINA DEL REY, CA 90292-5426
(310) 204-5510
(424) 384-5053
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A69816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A698160
—
CA
01
—
010066259
MEDICARE RAILROAD
CA
01
—
ZZZ05665Z
BLUE SHIELD CA
CA
Enumeration date
07/08/2006
Last updated
03/02/2018
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