Provider Demographics
NPI:1588726756
Name:ALANIZI, AYAD A (MD)
Entity type:Individual
Prefix:DR
First Name:AYAD
Middle Name:A
Last Name:ALANIZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 E GREEN ST STE 1071060E
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2408
Mailing Address - Country:US
Mailing Address - Phone:626-744-9018
Mailing Address - Fax:626-744-9075
Practice Address - Street 1:1060 E GREEN ST STE 107
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2413
Practice Address - Country:US
Practice Address - Phone:626-744-9018
Practice Address - Fax:626-744-9075
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44518174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44518Medicaid
CA00A445182Medicaid
CA00A445181Medicaid
CAA44518Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER