Organization
NORCAL PEDIATRIC GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADI GEORGE HADDAD M.D. (PRESIDENT)
(510) 813-4747
Entity
Organization
Contact information
Practice address
1776 YGNACIO VALLEY RD, STE 108, WALNUT CREEK, CA 94598-3190
(925) 939-9200
(925) 939-9205
Mailing address
8275 ROYALL OAKS DR, GRANITE BAY, CA 95746-9340
(510) 813-4747
(877) 992-2989
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
C51575
CA
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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