Provider Demographics
NPI:1588623144
Name:TADROS, GEORGE M (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:TADROS
Suffix:
Gender:
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:3080 BRISTOL ST STE 150
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3068
Mailing Address - Country:US
Mailing Address - Phone:877-430-7337
Mailing Address - Fax:877-430-7376
Practice Address - Street 1:24022 CALLE DE LA PLATA STE 500
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7612
Practice Address - Country:US
Practice Address - Phone:877-430-7337
Practice Address - Fax:877-430-7376
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN46124207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110010939Medicare PIN
H62429Medicare UPIN