Provider Demographics
NPI:1427741040
Name:FATIMA, BADIHA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BADIHA
Middle Name:
Last Name:FATIMA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 W 182ND ST APT 10
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-4728
Mailing Address - Country:US
Mailing Address - Phone:424-558-9658
Mailing Address - Fax:
Practice Address - Street 1:8317 DAVIS ST
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4918
Practice Address - Country:US
Practice Address - Phone:562-359-2087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA62771363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant