Jimmy Henry Faddis I, is a
Student In An Organized Health Care Education/training Program based in Chula Vista, California. Jimmy Henry Faddis I is licensed to practice in California (license number ) and his current practice location is
430 F St, Chula Vista, California. He can be reached at his office (for appointments etc.) via phone at
(619) 420-3620.
NPI number for Jimmy Henry Faddis I is 1922660695 and his current mailing address is 430 F St, Chula Vista, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1922660695.
Healthcare Provider's Profile
Full Name | Jimmy Henry Faddis I |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 430 F St, Chula Vista, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1922660695
- Provider Enumeration Date: 07/02/2019
- Last Update Date: 07/11/2019
Medical Identifiers
Medical identifiers for Jimmy Henry Faddis I such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1922660695 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jimmy Henry Faddis I is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jimmy Henry Faddis I, 430 F St, Chula Vista, CA 91910-3711 Ph: (619) 420-3620 | Jimmy Henry Faddis I, 430 F St, Chula Vista, CA 91910-3711 Ph: (619) 420-3620 |
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