MEDICARE: DR. FADI KATTAR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	51085	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D51085	OTHER	CA	DENTI-CAL

General Provider Information

NPI Number	:	1013035260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FADI KATTAR DDS

Provider Business Mailing Address
First Line	:	315 N ALMANSOR ST
Second Line	:
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-2622
Country	:	US
Telephone Number	:	626-222-0018
Fax Number	:

Provider Business Practice Location Address
First Line	:	8540 S SEPULVEDA BLVD STE 1210
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3819
Country	:	US
Telephone Number	:	424-253-3636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	11/03/2022

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Directions to “ DR. FADI KATTAR DDS” Practice Location

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