Provider Demographics
NPI:1548564107
Name:CHESTER A. HASDAY MD APC
Entity Type:Organization
Organization Name:CHESTER A. HASDAY MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HASDAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-273-4433
Mailing Address - Street 1:415 N CRESCENT DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4860
Mailing Address - Country:US
Mailing Address - Phone:310-273-4433
Mailing Address - Fax:310-273-1260
Practice Address - Street 1:415 N CRESCENT DR
Practice Address - Street 2:SUITE 300
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4860
Practice Address - Country:US
Practice Address - Phone:310-273-4433
Practice Address - Fax:310-273-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG43501261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA006435011Medicaid
CAG43501OtherSTATE LICENSE
0413880001Medicare NSC
CAG43501OtherSTATE LICENSE
CAG43501AMedicare PIN