Provider Demographics
NPI:1740982792
Name:FAHEL, NADIM (DC)
Entity type:Individual
Prefix:DR
First Name:NADIM
Middle Name:
Last Name:FAHEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 N LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3500
Mailing Address - Country:US
Mailing Address - Phone:909-988-2554
Mailing Address - Fax:
Practice Address - Street 1:235 N LAUREL AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3500
Practice Address - Country:US
Practice Address - Phone:909-988-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor