Provider Demographics
NPI:1700880218
Name:ADEEB, FAREEDA N (MD)
Entity Type:Individual
Prefix:
First Name:FAREEDA
Middle Name:N
Last Name:ADEEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FAREEDA
Other - Middle Name:N
Other - Last Name:SHARIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:275 O'CONNOR DR
Mailing Address - Street 2:STE 'B'
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128
Mailing Address - Country:US
Mailing Address - Phone:408-279-8798
Mailing Address - Fax:408-279-8777
Practice Address - Street 1:275 O'CONNOR DR
Practice Address - Street 2:STE 'B'
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-279-8798
Practice Address - Fax:408-279-8777
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA529960208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4042727Medicare UPIN