Provider Demographics
NPI:1043416670
Name:MOUNIR BELCADI, MD
Entity Type:Organization
Organization Name:MOUNIR BELCADI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:MOUNIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BELCADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-579-8703
Mailing Address - Street 1:3452 MENDOCINO AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2221
Mailing Address - Country:US
Mailing Address - Phone:707-579-8703
Mailing Address - Fax:707-579-8755
Practice Address - Street 1:3452 MENDOCINO AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2221
Practice Address - Country:US
Practice Address - Phone:707-579-8703
Practice Address - Fax:707-579-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA936422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI54727Medicare UPIN
CA00A936420Medicare ID - Type Unspecified