Provider Demographics
NPI:1730449760
Name:AL-SELHI, FADI GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:FADI
Middle Name:GEORGE
Last Name:AL-SELHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210S GRAND AVE 425
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-4294
Mailing Address - Country:US
Mailing Address - Phone:626-335-4466
Mailing Address - Fax:626-335-4476
Practice Address - Street 1:210 S GRAND AVE
Practice Address - Street 2:STE 408
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4282
Practice Address - Country:US
Practice Address - Phone:626-335-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32308111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor