Provider Demographics
NPI:1992884639
Name:MAGED AYAD MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:MAGED AYAD MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAGED
Authorized Official - Middle Name:
Authorized Official - Last Name:AYAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-953-9400
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:91505-4800
Mailing Address - Country:US
Mailing Address - Phone:818-953-9400
Mailing Address - Fax:
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:91505-4813
Practice Address - Country:US
Practice Address - Phone:818-953-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W17361Medicare ID - Type Unspecified