Provider Demographics
NPI:1174728612
Name:BITAR, FAHED GEORGEOS (MD)
Entity type:Individual
Prefix:DR
First Name:FAHED
Middle Name:GEORGEOS
Last Name:BITAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3452 E FOOTHILL BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3142
Mailing Address - Country:US
Mailing Address - Phone:626-793-2885
Mailing Address - Fax:626-396-9952
Practice Address - Street 1:315 N. THIRD AVE.
Practice Address - Street 2:SUITE 207
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723
Practice Address - Country:US
Practice Address - Phone:626-915-4700
Practice Address - Fax:626-214-7814
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2021-11-09
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Provider Licenses
StateLicense IDTaxonomies
CAA 84775207RC0000X
CAA84775207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADH340WMedicare PIN