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Organization

OMAR O. FADEEL, MD

Active
Parent organization
MEDVANTX, INC
Other names
Office of Dr. Omar Fadeel
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDVANTX, INC
Authorized official
KENNY HEINE (VP OPS)
(858) 964-1506
Entity
Organization

Contact information

Practice address
3356 W BALL RD, 100, ANAHEIM, CA 92804-3702
(714) 827-6625
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A44522
CA

Other

Enumeration date
11/09/2012
Last updated
11/09/2012
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