Provider Demographics
NPI:1124100144
Name:AIACHE, ADRIEN ELIE (MD)
Entity type:Individual
Prefix:
First Name:ADRIEN
Middle Name:ELIE
Last Name:AIACHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MS
Other - First Name:DARLENE
Other - Middle Name:BETTYGEAN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9884 S. SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212
Mailing Address - Country:US
Mailing Address - Phone:310-276-5856
Mailing Address - Fax:310-286-9471
Practice Address - Street 1:9884 S. SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-276-5856
Practice Address - Fax:310-286-9471
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24587208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA24587AMedicare PIN
CAW19465Medicare PIN
CAA24036Medicare UPIN