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DR. RIAD MARDOUM M.D.
NPI 1417050584
Pediatrics in San Diego, CA

Active since September 06, 2006
4077 5TH AVE, SAN DIEGO, CA 92103(619) 260-7046(619) 686-3843 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Riad Mardoum M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RIAD MARDOUM M.D. (NPI 1417050584) is an individual pediatrics provider in San Diego, California, licensed in California (A36720) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1417050584
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. RIAD MARDOUMCredential: M.D.
Location Address4077 5TH AVESan Diego, CA 92103-2105
Mailing Address4077 5th AveSan Diego, CA 92103-2105 · (619) 260-7046 · Fax (619) 686-3843
Phone(619) 260-7046
Fax(619) 686-3843
Sole ProprietorYes
Enumeration DateSeptember 6, 2006
Last NPPES UpdateJuly 21, 2022
✔ NPI 1417050584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A36720
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
4077 5TH AVE, San Diego, CA 92103
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GERALDINE MARIE CROWLE PH.D.
Psychologist (Clinical)
4077 5TH AVE, BEHAVIORAL HEALTH OUTPATIENT - LEVEL D
SAN DIEGO, CA 92103
San Diego County (619) 260-7066
JOSEPH ARTHUR ANDERSON PHARMD
Pharmacist
4077 5TH AVE
SAN DIEGO, CA 92103
San Diego County (858) 832-2478
REJOYCE T STEFANIUK
Nurse Practitioner (Primary Care)
4077 5TH AVE
SAN DIEGO, CA 92103
San Diego County (773) 219-4453
JOSEPH SAM KAZANCHI MD
Hospitalist
4077 5TH AVE, MER 127
SAN DIEGO, CA 92103
San Diego County (619) 484-8573
RIMA SCHNEIDER DPT
Physical Therapist
4077 5TH AVE
SAN DIEGO, CA 92103
San Diego County (858) 832-2478
MAGGIE FRYE
Nurse Practitioner (Adult Health)
4077 5TH AVE
SAN DIEGO, CA 92103
San Diego County (196) 868-3800
KAREN VIRGINIA MORGAN M.D
Emergency Medicine
4077 5TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 260-7000
MR. PAUL JAMES DEMEULES LCSW
Social Worker (Clinical)
4077 5TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 260-7066

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Riad Mardoum's NPI number?

The NPI number for Riad Mardoum is 1417050584. It was assigned to this individual provider in the NPPES registry on September 6, 2006.

Where is Riad Mardoum located?

Riad Mardoum practices at 4077 5th Ave, San Diego, CA 92103. The listed phone number is (619) 260-7046.

What is Riad Mardoum's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Riad Mardoum was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.