Provider Demographics
NPI:1275580037
Name:ABDULHADI, YOUMNA M (MD)
Entity Type:Individual
Prefix:
First Name:YOUMNA
Middle Name:M
Last Name:ABDULHADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 PARK BLVD APT 419
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-0917
Mailing Address - Country:US
Mailing Address - Phone:513-638-1575
Mailing Address - Fax:
Practice Address - Street 1:3740 PARK BLVD APT 419
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-0917
Practice Address - Country:US
Practice Address - Phone:513-638-1575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33233207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1275580037OtherMEDICAL
AZ33233OtherAZ STATE MEDICAL LICENSE
AZ883927Medicaid
AZAZ0449730OtherBCBSAZ
AZ883927Medicaid
AZ33233OtherAZ STATE MEDICAL LICENSE
AZZ110086Medicare PIN