Provider Demographics
NPI:1609977164
Name:RADING, FAIZA (MD)
Entity Type:Individual
Prefix:
First Name:FAIZA
Middle Name:
Last Name:RADING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5219
Mailing Address - Country:US
Mailing Address - Phone:916-733-3333
Mailing Address - Fax:
Practice Address - Street 1:3160 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5219
Practice Address - Country:US
Practice Address - Phone:916-733-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7651652OtherAETNA
CA90142718OtherPACIFICARE
CA00A859570Medicaid
CA2246963OtherFIRST HEALTH
CA2361191OtherUNITED HEALTHCARE
CAMCMG362400OtherWESTERN HEALTH ADVANTAGE
CA00A859570OtherBLUE SHIELD
CA107214OtherHEALTH NET
CA1838791OtherGREAT WEST
CA239471OtherINTERPLAN
CAA85957OtherBLUE CROSS
CA0536293OtherCIGNA
CA000810648472OtherPHCS
CA107214OtherHEALTH NET
I02394Medicare UPIN