Individual
DR. GEORGE Z. FADDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8851 CENTER DR, STE 505, LA MESA, CA 91942-3017
(619) 461-3880
(619) 461-3895
Mailing address
4225 EXECUTIVE SQ STE 450, LA JOLLA, CA 92037-8411
(858) 810-0000
(858) 268-1911
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A44918
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A449180
—
CA
01
—
CA122838
NO. CALIFORNIA PTAN
CA
01
—
WA44918D
SO. CALIFORNIA PTAN
CA
Enumeration date
06/20/2005
Last updated
01/26/2021
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