Healthcare Provider Details

I. General information

NPI: 1598996274
Provider Name (Legal Business Name): NICHOLAS D. LAHAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 05/31/2020
Certification Date: 05/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 N ROXBURY DR STE 207
BEVERLY HILLS CA
90210-5017
US

IV. Provider business mailing address

5310 NOBLE AVE
SHERMAN OAKS CA
91411-3907
US

V. Phone/Fax

Practice location:
  • Phone: 310-403-3514
  • Fax:
Mailing address:
  • Phone: 310-403-3514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA111499
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: