Individual provider Active NPI

Chafik Dakak, M.D.

  • Health Maintenance Organization
  • Lynwood, CA
National Provider Identifier
1376563957
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
C42844 Issued in CA
Practice address
3737 Martin Luther King Blvd.
Suite 205
Lynwood, CA 90262
Phone
(310) 604-0105
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X C42844 CA Primary

Addresses

Primary practice location

3737 Martin Luther King Blvd.
Suite 205
Lynwood, CA 90262

Mailing address

3737 Martin L. King Blvd
#205
Lynwood, CA 90262
Phone (310) 604-0105

Other identifiers 1

IdentifierTypeStateIssuer
00C428441MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C42844CAMDHealth Maintenance Organization

Practice roles

OrganizationSpecialtyStatusNew patients
Chafik Dakak, M.D., Inc. Current Accepting new patients
St Francis Medical Center Past Accepting new patients

Locations

3301 Beechwood Ave
Lynwood, CA 90262
Phone (310) 604-0105

3737 Martin Luther King Jr Blvd
Ste 205
Lynwood, CA 90262
Phone (310) 604-0105

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1376563957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARTIN L. KING BLVD",
            "address_2": "#205",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "90262",
            "telephone_number": "310-604-0105",
            "fax_number": "310-604-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING BLVD.",
            "address_2": "SUITE 205",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "90262",
            "telephone_number": "310-604-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKAK",
        "first_name": "CHAFIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "C42844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C428441",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.