Provider Demographics
NPI:1346465556
Name:RABADI, FARES MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:FARES
Middle Name:MICHAEL
Last Name:RABADI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 N UNRUH AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-2038
Mailing Address - Country:US
Mailing Address - Phone:626-919-0191
Mailing Address - Fax:626-919-0149
Practice Address - Street 1:919 N UNRUH AVE
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-2038
Practice Address - Country:US
Practice Address - Phone:626-919-0191
Practice Address - Fax:626-919-0149
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29089111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor