MEDICARE: HAYDER ALI KADHIM

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	122300000X	Dentist	112981	CA

General Provider Information

NPI Number	:	1689506883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYDER ALI KADHIM

Provider Business Mailing Address
First Line	:	325 W ADAMS BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-2659
Country	:	US
Telephone Number	:	313-529-8751
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 W ADAMS BLVD # 4090A
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90007-2659
Country	:	US
Telephone Number	:	313-529-8751
Fax Number	:

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ HAYDER ALI KADHIM ” Practice Location

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