Provider Demographics
NPI:1447695325
Name:IYER, ADITYA KRISHNA (MD)
Entity type:Individual
Prefix:
First Name:ADITYA
Middle Name:KRISHNA
Last Name:IYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2020 SANTA MONICA BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2023
Mailing Address - Country:US
Mailing Address - Phone:310-829-8868
Mailing Address - Fax:
Practice Address - Street 1:11550 INDIAN HILLS RD STE 261
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1244
Practice Address - Country:US
Practice Address - Phone:818-847-6570
Practice Address - Fax:310-582-7495
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1318422085N0700X, 207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology