| Emad Tadros Md A Prof Corp | |
|
4060 Fourth Ave Ste 102 San Diego CA 92103-2120 | |
| (619) 692-8118 | |
| (619) 800-7385 |
| Full Name | Emad Tadros Md A Prof Corp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4060 Fourth Ave Ste 102, San Diego, California |
| Authorized Official Name and Position | Emad G Tadros Md A Prof Corp (PSYCHIATRIST) |
| Authorized Official Contact | 6196928118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emad Tadros Md A Prof Corp 4060 Fourth Ave Ste 102 San Diego CA 92103-2120 Ph: (619) 692-8118 | Emad Tadros Md A Prof Corp 4060 Fourth Ave Ste 102 San Diego CA 92103-2120 Ph: (619) 692-8118 |
| NPI Number | 1811185804 |
|---|---|
| Provider Enumeration Date | 10/04/2007 |
| Last Update Date | 06/23/2014 |
| Medicare PECOS PAC ID | 2567415409 |
|---|---|
| Medicare Enrollment ID | O20050302000952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811185804 | NPI | - | NPPES |
| 00A495000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A49500 (California) | Primary |
| Provider Name | Emad G Tadros |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487696878 PECOS PAC ID: 2567352750 Enrollment ID: I20040319000702 |
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