Provider Demographics
NPI:1578220273
Name:MAADARANI, EMAD AHMAD (FNP)
Entity type:Individual
Prefix:
First Name:EMAD
Middle Name:AHMAD
Last Name:MAADARANI
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 E PALMDALE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-1334
Mailing Address - Country:US
Mailing Address - Phone:661-400-9193
Mailing Address - Fax:
Practice Address - Street 1:2270 E PALMDALE BLVD STE F
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-1334
Practice Address - Country:US
Practice Address - Phone:661-855-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95152258163W00000X
CA95029787363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse