Provider Demographics
NPI:1497132583
Name:ALBADANI, FAWAZ ALBADANI (CHIROPRACTOR)
Entity Type:Individual
Prefix:DR
First Name:FAWAZ
Middle Name:ALBADANI
Last Name:ALBADANI
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 SANTA RITA RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3467
Mailing Address - Country:US
Mailing Address - Phone:415-420-0867
Mailing Address - Fax:
Practice Address - Street 1:6700 SANTA RITA RD
Practice Address - Street 2:SUITE D
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3467
Practice Address - Country:US
Practice Address - Phone:415-420-0867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor