Provider Demographics
NPI:1396855235
Name:KADRY, AMAD EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:AMAD
Middle Name:EDWARD
Last Name:KADRY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2302
Mailing Address - Country:US
Mailing Address - Phone:949-923-3277
Mailing Address - Fax:855-812-5865
Practice Address - Street 1:145 THUNDER DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6010
Practice Address - Country:US
Practice Address - Phone:760-941-9002
Practice Address - Fax:760-630-2515
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA32917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA26971Medicare UPIN
CAWA32917JMedicare PIN