Provider Demographics
NPI:1750471801
Name:CHANIN, ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:
Last Name:CHANIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-3003
Mailing Address - Country:US
Mailing Address - Phone:310-322-1611
Mailing Address - Fax:310-322-4589
Practice Address - Street 1:455 MAIN ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-3003
Practice Address - Country:US
Practice Address - Phone:310-322-1611
Practice Address - Fax:310-322-4589
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA22013207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0302822OtherDEA LIC. # DR. CHANIN
CAA22013Medicare UPIN
CAWA22013DMedicare ID - Type UnspecifiedARNOLD CHANIN MD