Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A89880 | CA |
N | 208200000X | Surgeon | A89880 | CA |
N | 208600000X | Surgeon | A89880 | CA |
NPI | 1700050598 |
---|---|
Provider Name | Fady Michael Kaldas |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-7002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 30/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A898800 | (05) | CA |