Provider Demographics
NPI:1013545961
Name:CHAHINE, ALI DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:DAVID
Last Name:CHAHINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30839 E THOUSAND OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-4039
Mailing Address - Country:US
Mailing Address - Phone:818-850-8707
Mailing Address - Fax:877-673-1696
Practice Address - Street 1:30839 E THOUSAND OAKS BLVD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4039
Practice Address - Country:US
Practice Address - Phone:818-850-8707
Practice Address - Fax:877-673-1696
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301507240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program