1861553992 NPI number — MRS. MAI M LAYYOUS L.AC, O.M.D

Table of content: MRS. MAI M LAYYOUS L.AC, O.M.D (NPI 1861553992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861553992 NPI number — MRS. MAI M LAYYOUS L.AC, O.M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAYYOUS
Provider First Name:
MAI
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.AC, O.M.D
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAYYOUS
Provider Other First Name:
MAI
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.AC, O.M.D
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1861553992
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:
885 E OAK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANAHEIM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92805-4135
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-928-6307
Provider Business Mailing Address Fax Number:
714-776-6307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1741 W ROMNEYA DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
ANAHEIM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92801-1805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-928-6307
Provider Business Practice Location Address Fax Number:
714-776-3678
Provider Enumeration Date:
12/13/2006

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: 171100000X , with the licence number:  L.AC 8335 , 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)





Copyright © 2007-2025 www.npivalidator.com