| W. Al-fadly, M.d., Inc | |
|
16000 S Vermont Ave Gardena CA 90247-4552 | |
| (310) 324-1183 | |
| (310) 324-4358 |
| Full Name | W. Al-fadly, M.d., Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 16000 S Vermont Ave, Gardena, California |
| Authorized Official Name and Position | Waleed S Al-fadly (PRESIDENT) |
| Authorized Official Contact | 3103241183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| W. Al-fadly, M.d., Inc 16000 S Vermont Ave Gardena CA 90247-4552 Ph: (310) 324-1183 | W. Al-fadly, M.d., Inc 16000 S Vermont Ave Gardena CA 90247-4552 Ph: (310) 324-1183 |
| NPI Number | 1134475171 |
|---|---|
| Provider Enumeration Date | 07/27/2012 |
| Last Update Date | 07/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134475171 | NPI | - | NPPES |
| 00A205453 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A20545 (California) | Primary |
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