Provider Demographics
NPI:1649599366
Name:ATTIA, ENAS FAROUK (MD)
Entity Type:Individual
Prefix:DR
First Name:ENAS
Middle Name:FAROUK
Last Name:ATTIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 E ALLUVIAL AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3832
Mailing Address - Country:US
Mailing Address - Phone:559-322-5515
Mailing Address - Fax:559-322-5915
Practice Address - Street 1:1515 E ALLUVIAL AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3832
Practice Address - Country:US
Practice Address - Phone:559-322-5515
Practice Address - Fax:559-322-5915
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA110082208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics