Basic Information
| Provider Information | |||||||||
| NPI: | 1750460143 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HADI | ||||||||
| FirstName: | SUHAD | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3160 FOLSOM BLVD | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167333333 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3160 FOLSOM BLVD | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9167333333 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | E4462 | CA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 00E44620 | 01 | CA | BLUE SHIELD | OTHER | 9781330 | 01 | CA | CIGNA | OTHER | MCMG238900 | 01 | CA | WESTERN HEALTH ADVANTAGE | OTHER | 90132937 | 01 | CA | PACIFICARE | OTHER | 000E44620 | 05 | CA | MEDICAID | 2097685 | 01 | CA | FIRST HEALTH | OTHER | 7305152 | 01 | CA | AETNA | OTHER | 90812 | 01 | CA | INTERPLAN | OTHER | E4462 | 01 | CA | BLUE CROSS | OTHER | 098993 | 01 | CA | HEALTH NET | OTHER | 1708142 | 01 | CA | GREAT WEST | OTHER | 2025418 | 01 | CA | UNITED HEALTHCARE | OTHER |