Individual
FADI ALHATEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 N ROBERTSON BLVD STE 505, BEVERLY HILLS, CA 90211
(310) 385-3530
(310) 385-3322
Mailing address
PO BOX 54679, LOS ANGELES, CA 90054-0679
Taxonomy
Speciality
Code
Description
License number
State
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
Primary
C159408
CA
208VP0000X
Pain Medicine Physician
D77403
MD
208VP0014X
Interventional Pain Medicine Physician
D77403
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210089
BCBS
MI
01
—
1467672485
ANTHEM
WI
05
—
1467672485
—
MI
05
—
1467672485
—
WI
Enumeration date
05/01/2007
Last updated
12/12/2018
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