Provider Demographics
NPI:1578577920
Name:CHAHIN, FADI (MD)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:
Last Name:CHAHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10628
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-3628
Mailing Address - Country:US
Mailing Address - Phone:310-274-2763
Mailing Address - Fax:310-275-0477
Practice Address - Street 1:433 N CAMDEN DR
Practice Address - Street 2:STE 1170
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4409
Practice Address - Country:US
Practice Address - Phone:310-274-2763
Practice Address - Fax:310-275-0477
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA837942082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A837940Medicaid
CAI09511Medicare UPIN
CAWA83794AMedicare PIN