Provider Demographics
NPI:1851407605
Name:HADDEN, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:HADDEN
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 1:5151 N. PALM AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2221
Mailing Address - Country:US
Mailing Address - Phone:559-226-1200
Mailing Address - Fax:559-226-8432
Practice Address - Street 1:5151 N. PALM AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2221
Practice Address - Country:US
Practice Address - Phone:559-226-1200
Practice Address - Fax:559-226-8432
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG16077174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA208849Medicaid
CAA39698Medicare UPIN
CA208849Medicaid