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FADI ALHATEM M.D.
Pain Medicine >> Pain Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1467672485
Individual Registrant: FADI ALHATEM M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
250 N ROBERTSON BLVD STE 505 BEVERLY HILLS, CA 90211 US
Tel: 310-385-3530 Fax: 310-385-3322
Tel: 310-385-3530 Fax: 310-385-3322
Contact information for business:
PO BOX 54679 LOS ANGELES, CA 90054-0679 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1467672485
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 208VP0000X | Allopathic & Osteopathic Physicians Pain Medicine Pain Medicine | MD | D77403 |
| N | 208VP0014X | Allopathic & Osteopathic Physicians Pain Medicine | MD | D77403 |
| Y | 2084P2900X | Allopathic & Osteopathic Physicians Psychiatry & Neurology | CA | C159408 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1467672485 | MI | 05 | |
| 1467672485 | WI | 05 | |
| BCBS | 0210089 | MI | 01 |
| ANTHEM | 1467672485 | WI | 01 |
