Provider Demographics
NPI:1992718332
Name:AYAD, MAGED (MD)
Entity type:Individual
Prefix:
First Name:MAGED
Middle Name:
Last Name:AYAD
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 1:2601 W ALAMEDA AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-953-9400
Mailing Address - Fax:818-953-9420
Practice Address - Street 1:2601 W ALAMEDA AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505
Practice Address - Country:US
Practice Address - Phone:818-953-9400
Practice Address - Fax:818-953-9420
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A56313Medicare ID - Type Unspecified
Y12027Medicare UPIN