Provider Demographics
NPI:1285662122
Name:HADEED, ADNAN JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:ADNAN
Middle Name:JOSEPH
Last Name:HADEED
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 1:607 GEORGIA STREET
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-6123
Mailing Address - Country:US
Mailing Address - Phone:707-554-8244
Mailing Address - Fax:707-554-1213
Practice Address - Street 1:607 GEORGIA STREET
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-6123
Practice Address - Country:US
Practice Address - Phone:707-554-8244
Practice Address - Fax:707-554-1213
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA033084207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00330840Medicaid
CA00330840Medicare ID - Type Unspecified
CA00330840Medicaid