Provider Demographics
NPI:1043238371
Name:NAYYAR, KANWAL K (MD)
Entity type:Individual
Prefix:DR
First Name:KANWAL
Middle Name:K
Last Name:NAYYAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14901 RINALDI ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1204
Mailing Address - Country:US
Mailing Address - Phone:818-898-9898
Mailing Address - Fax:818-898-9899
Practice Address - Street 1:14901 RINALDI ST
Practice Address - Street 2:SUITE 325
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1204
Practice Address - Country:US
Practice Address - Phone:818-898-9898
Practice Address - Fax:818-898-9899
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA562262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A562260OtherMEDICAL
CAW15677Medicare UPIN
CA00A562260OtherMEDICAL