Provider Type Icon

DR. RIAD MARDOUM M.D. NPI 1417050584


NPI Information

NPI: 1417050584
Provider Name: DR. RIAD MARDOUM, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
4077 5TH AVE
SAN DIEGO, CA
ZIP 92103
Phone: (619) 260-7046
Get Directions

DR. Riad Mardoum, M.D. is a pediatrics in San Diego, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Riad Mardoum, M.D. NPI is 1417050584. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4077 5TH AVE
SAN DIEGO, CA
ZIP 92103-105
Phone: (619) 260-7046
Fax: (619) 686-3843

The enumeration date for this NPI number is 9/6/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsA36720CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.