Provider Demographics
NPI:1902465370
Name:PAYZANT, NICK L
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:L
Last Name:PAYZANT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 MICHELSON DR STE 225
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1307
Mailing Address - Country:US
Mailing Address - Phone:949-298-3200
Mailing Address - Fax:
Practice Address - Street 1:2151 MICHELSON DR STE 225
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1307
Practice Address - Country:US
Practice Address - Phone:949-298-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker