Provider Demographics
NPI:1902876683
Name:ELSAADI, MAGDI SABRI (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDI
Middle Name:SABRI
Last Name:ELSAADI
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 1:2015 N WATERMAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-4810
Mailing Address - Country:US
Mailing Address - Phone:909-881-9918
Mailing Address - Fax:909-881-9927
Practice Address - Street 1:2015 N WATERMAN AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4810
Practice Address - Country:US
Practice Address - Phone:909-557-0135
Practice Address - Fax:909-886-1798
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A495070Medicaid
E57243Medicare UPIN
CA00A495070Medicaid