Provider Demographics
NPI:1265879001
Name:SADEK, AHMED
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:SADEK
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 1:4370 W 138TH ST
Mailing Address - Street 2:APT#112
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-7137
Mailing Address - Country:US
Mailing Address - Phone:310-242-3868
Mailing Address - Fax:
Practice Address - Street 1:4370 W 138TH ST
Practice Address - Street 2:APT#112
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-7137
Practice Address - Country:US
Practice Address - Phone:310-242-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28382225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist