Individual
DR. HAMID R FADAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
26932 OSO PKWY, SUITE 275, MISSION VIEJO, CA 92691-5815
(949) 916-8100
(949) 916-8555
Mailing address
26932 OSO PKWY, SUITE 275, MISSION VIEJO, CA 92691-5815
(949) 916-8100
(949) 916-8555
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
1080 DO
AL
208VP0014X
Interventional Pain Medicine Physician
Primary
20A11189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB207387
PTAN
—
Enumeration date
05/12/2009
Last updated
02/12/2014
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