Provider Demographics
NPI:1831900257
Name:RAFID A H FADUL M.D., P.C.
Entity type:Organization
Organization Name:RAFID A H FADUL M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFID
Authorized Official - Middle Name:
Authorized Official - Last Name:FADUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-557-5361
Mailing Address - Street 1:548 MARKET ST # 31758
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-5401
Mailing Address - Country:US
Mailing Address - Phone:877-897-6320
Mailing Address - Fax:
Practice Address - Street 1:1325 J ST STE 1550
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-2976
Practice Address - Country:US
Practice Address - Phone:877-897-6320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty