| Doctor Name: | DR. FADY NABIL ELIAS |
| NPI Number: | 1063650844 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A122000 |
| Business Practice Address: | 720 Paularino Ave Ste 100 Costa Mesa, CA - 926266917 |
| Business Phone Number: | 6319651286 |
| Business Fax Number: | |
| Mailing Address: | 31 Golf Dr, ALISO VIEJO |
| State: | CA |
| Postal Code: | 926561633 |
| Phone Number: | 7145219703 |
| Fax Number: | |
| NPI Enumeration Date: | 02/02/2009 |
| NPI Last Update Date: | 12/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A122000 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |