Individual
ALI FADHIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
340 4TH AVE STE 9, CHULA VISTA, CA 91910-3813
(619) 426-9731
(619) 426-9733
Mailing address
340 4TH AVE STE 9, CHULA VISTA, CA 91910-3813
(619) 426-9731
(619) 426-9733
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A145663
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A145663
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145663
CA LICENSE
CA
01
—
73114
GA COMPOSITE MEDICAL BOARD
GA
01
—
A145663
CA LICENSE
CA
Enumeration date
06/27/2012
Last updated
11/27/2023
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