Basic Information
Provider Information
NPI: 1558402586
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EL-SALIBI
FirstName: FADI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10001 S EASTERN AVE STE 307
Address2:  
City: HENDERSON
State: NV
PostalCode: 890523908
CountryCode: US
TelephoneNumber: 7027768300
FaxNumber: 7027768303
Practice Location
Address1: 10001 S EASTERN AVE STE 307
Address2:  
City: HENDERSON
State: NV
PostalCode: 890523908
CountryCode: US
TelephoneNumber: 7027768300
FaxNumber: 7027768303
Other Information
ProviderEnumerationDate: 02/11/2007
LastUpdateDate: 09/03/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X11000NVY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

ID Information
IDTypeStateIssuerDescription
10050520705NV MEDICAID


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