Provider Demographics
NPI:1760708341
Name:AL-AEDAN, NAIF MANSOUR (MBBS)
Entity Type:Individual
Prefix:DR
First Name:NAIF
Middle Name:MANSOUR
Last Name:AL-AEDAN
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2755 HERNDON AVE
Mailing Address - Street 2:CLOVIS COMMUNITY HOSPITAL
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6800
Mailing Address - Country:US
Mailing Address - Phone:559-228-4222
Mailing Address - Fax:559-228-4299
Practice Address - Street 1:2755 HERNDON AVE
Practice Address - Street 2:CLOVIS COMMUNITY HOSPITAL
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6800
Practice Address - Country:US
Practice Address - Phone:559-228-4222
Practice Address - Fax:559-228-4299
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA126155208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist