Provider Demographics
NPI:1043289788
Name:NADEL, HAROLD IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:IVAN
Last Name:NADEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CORTE SEVILLA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-6872
Mailing Address - Country:US
Mailing Address - Phone:949-218-0984
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL, CAMP PENDLETON
Practice Address - Street 2:BLDG H100 ATTENTION: CODE 094
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5191
Practice Address - Country:US
Practice Address - Phone:760-725-3147
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC266932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC26693OtherSTATE MEDICAL LICENSE
CAC26693OtherSTATE MEDICAL LICENSE