Provider Demographics
NPI:1740593797
Name:FADUL, ZAID (MD)
Entity type:Individual
Prefix:DR
First Name:ZAID
Middle Name:
Last Name:FADUL
Suffix:
Gender:M
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:PO BOX 21506
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85277-1506
Mailing Address - Country:US
Mailing Address - Phone:480-490-6656
Mailing Address - Fax:480-674-9960
Practice Address - Street 1:17822 BEACH BLVD STE 321
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7170
Practice Address - Country:US
Practice Address - Phone:725-888-8992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS26309207Q00000X
OH35.122879207Q00000X
NY290033207Q00000X
MN64766207Q00000X
NC2017-01389207Q00000X
CAA127597207Q00000X
AZ47802208M00000X
PAMD450045207Q00000X, 101Y00000X
TXP9339207Q00000X
GA71067207Q00000X
IL036147413207Q00000X
MI4301113244207Q00000X
CT51568207Q00000X
WI219-320207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor