Provider Demographics
NPI:1598728347
Name:LAD, CHIMAN (DDS)
Entity Type:Individual
Prefix:
First Name:CHIMAN
Middle Name:
Last Name:LAD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5813 TEMPLE CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2113
Mailing Address - Country:US
Mailing Address - Phone:626-287-4094
Mailing Address - Fax:626-287-7258
Practice Address - Street 1:5813 TEMPLE CITY BLVD
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780
Practice Address - Country:US
Practice Address - Phone:626-287-4094
Practice Address - Fax:626-287-7258
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice