Individual
FADI GEORGE HADDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5201 DEER VALLEY RD STE 1E, ANTIOCH, CA 94531-7430
(925) 350-8855
(925) 350-8860
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
2080P0206X
Pediatric Gastroenterology Physician
K4448
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C515750
—
CA
01
—
450-107-8
ECFMG
—
01
—
C51575
MEDICAL LICENSE
CA
Enumeration date
07/24/2006
Last updated
03/07/2023
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