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NPI Code Detail

MEDICARE: LISA MARTINE CHAIKEN MD

MEDICARE: LISA MARTINE CHAIKEN MD
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
12085R0001XRadiation Oncology PhysicianG66880CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2920002903OTHERRAILROAD MEDICARE
3P00461553OTHERCARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528062023
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARTINE CHAIKEN MD
Provider Business Mailing Address
First Line : PO BOX 513969
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-3969
Country : US
Telephone Number : 310-335-4065
Fax Number : 310-335-4098
Provider Business Practice Location Address
First Line : 2121 SANTA MONICA BLVD
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2303
Country : US
Telephone Number : 310-829-8913
Fax Number : 310-315-6168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 11/18/2020

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Directions to “ LISA MARTINE CHAIKEN MD” Practice Location

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