Provider Demographics
NPI:1114382058
Name:AL-HELO, FADY TALAL (DPT)
Entity type:Individual
Prefix:DR
First Name:FADY
Middle Name:TALAL
Last Name:AL-HELO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7252 KITTYHAWK ST
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-2914
Mailing Address - Country:US
Mailing Address - Phone:909-767-2716
Mailing Address - Fax:
Practice Address - Street 1:17051 SIERRA LAKES PKWY STE 204
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-1274
Practice Address - Country:US
Practice Address - Phone:909-686-6826
Practice Address - Fax:909-587-2020
Is Sole Proprietor?:No
Enumeration Date:2015-12-18
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43246225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist