1134240849 NPI number — MR. KHALED NAIM BAYAA KHALED BAYAA

Table of content: MR. KHALED NAIM BAYAA KHALED BAYAA (NPI 1134240849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134240849 NPI number — MR. KHALED NAIM BAYAA KHALED BAYAA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAYAA
Provider First Name:
KHALED
Provider Middle Name:
NAIM
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
KHALED BAYAA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAYAA
Provider Other First Name:
KHALED
Provider Other Middle Name:
NAIM
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
KHALED BAYAA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1134240849
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 EAGLE PT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IRVINE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92604-3352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-697-4006
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 EAGLE PT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92604-3352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
949-697-4006
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  4074 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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