Provider Demographics
NPI:1235450305
Name:TCHEKMEDYIAN, NISHAN (MD)
Entity Type:Individual
Prefix:
First Name:NISHAN
Middle Name:
Last Name:TCHEKMEDYIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NISHAN
Other - Middle Name:
Other - Last Name:TCHEKMEDYIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 512185
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-0185
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19671 BEACH BLVD STE 315
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5904
Practice Address - Country:US
Practice Address - Phone:714-252-9415
Practice Address - Fax:714-963-8407
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137047207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA243962OtherLIMITED BETH ISRAEL DEACONESS MEDICAL CENTER