Provider Demographics
NPI:1063435493
Name:DOUDIKIAN-SCAFF, NAYIRI (MD)
Entity type:Individual
Prefix:DR
First Name:NAYIRI
Middle Name:
Last Name:DOUDIKIAN-SCAFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:SUITE 168
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2401
Mailing Address - Country:US
Mailing Address - Phone:626-432-4600
Mailing Address - Fax:626-432-4607
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE 168
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-432-4600
Practice Address - Fax:626-432-4607
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67181208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A671810Medicaid
CAWA67181AMedicare ID - Type Unspecified
CAH91209Medicare UPIN