Provider Demographics
NPI:1396084695
Name:GEORGES, ADEL FAYEZ
Entity type:Individual
Prefix:MR
First Name:ADEL
Middle Name:FAYEZ
Last Name:GEORGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 S WEBSTER AVE
Mailing Address - Street 2:APT. 107
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-7315
Mailing Address - Country:US
Mailing Address - Phone:714-829-5780
Mailing Address - Fax:
Practice Address - Street 1:716 S WEBSTER AVE
Practice Address - Street 2:APT. 107
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-7315
Practice Address - Country:US
Practice Address - Phone:714-829-5780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230583164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse