Provider Demographics
NPI:1194977405
Name:DAHDAL, NEZAR N (MD)
Entity type:Individual
Prefix:DR
First Name:NEZAR
Middle Name:N
Last Name:DAHDAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24002 VIA FABRICANTE STE 201
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-3931
Mailing Address - Country:US
Mailing Address - Phone:623-200-3746
Mailing Address - Fax:
Practice Address - Street 1:5421 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4751
Practice Address - Country:US
Practice Address - Phone:480-690-7779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ46720208M00000X, 207R00000X
NY250348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist