Provider Demographics
NPI:1154701829
Name:WINDY A. OLAYA, M.D., INC.
Entity type:Organization
Organization Name:WINDY A. OLAYA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WINDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OLAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-564-9225
Mailing Address - Street 1:1310 W STEWART DR # 511
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3854
Mailing Address - Country:US
Mailing Address - Phone:714-564-9225
Mailing Address - Fax:855-230-1459
Practice Address - Street 1:1310 W STEWART DR # 511
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-564-9225
Practice Address - Fax:552-301-4598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1048242086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8051041Medicaid