Provider Demographics
NPI:1356540322
Name:ADEL ELDAHMY M.D. INCORPORATED
Entity type:Organization
Organization Name:ADEL ELDAHMY M.D. INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELDAHMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-597-7575
Mailing Address - Street 1:1760 TERMINO AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2105
Mailing Address - Country:US
Mailing Address - Phone:562-597-7575
Mailing Address - Fax:562-498-8309
Practice Address - Street 1:1760 TERMINO AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2105
Practice Address - Country:US
Practice Address - Phone:562-597-7575
Practice Address - Fax:562-498-8309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37156101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W12143Medicare PIN