Individual
LISA MARTINE CHAIKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 829-8913
(310) 315-6168
Mailing address
PO BOX 513969, LOS ANGELES, CA 90051-3969
(310) 335-4065
(310) 335-4098
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G66880
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G668800
—
CA
05
—
1528062023
—
CA
01
—
920002903
RAILROAD MEDICARE
—
01
—
P00461553
RAILROAD MEDICARE
CA
Enumeration date
06/13/2005
Last updated
11/18/2020
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