Provider Demographics
NPI:1962561274
Name:ZADA, FAITH SALIH (MD)
Entity type:Individual
Prefix:PROF
First Name:FAITH
Middle Name:SALIH
Last Name:ZADA
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:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3611 MARTIN LUTHER KING BLVD
Practice Address - Street 2:#105
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262
Practice Address - Country:US
Practice Address - Phone:310-639-3836
Practice Address - Fax:310-378-4458
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30138208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A301380Medicaid
AS9051006OtherDEA FEDERAL
B50127Medicare UPIN
00A301380Medicare ID - Type Unspecified