Provider Demographics
NPI:1760661383
Name:ALBADAWI, FERAS B
Entity Type:Individual
Prefix:DR
First Name:FERAS
Middle Name:B
Last Name:ALBADAWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 SAN CARLOS TRAIL
Mailing Address - Street 2:P.O.BOX: 2144
Mailing Address - City:FRAIZERPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93225-2144
Mailing Address - Country:US
Mailing Address - Phone:661-204-8716
Mailing Address - Fax:661-245-3648
Practice Address - Street 1:3412 SAN CARLOS TRAIL
Practice Address - Street 2:P.O.BOX: 2144
Practice Address - City:FRAIZERPARK
Practice Address - State:CA
Practice Address - Zip Code:93225-2144
Practice Address - Country:US
Practice Address - Phone:661-204-8716
Practice Address - Fax:661-245-3648
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13433152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist