Provider Demographics
NPI:1689472060
Name:AL-FAYIZ, HADEEL HAKIM
Entity type:Individual
Prefix:
First Name:HADEEL
Middle Name:HAKIM
Last Name:AL-FAYIZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8187 BRANDING IRON LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-6613
Mailing Address - Country:US
Mailing Address - Phone:951-905-0774
Mailing Address - Fax:
Practice Address - Street 1:8187 BRANDING IRON LN
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-6613
Practice Address - Country:US
Practice Address - Phone:951-905-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA901891835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care