Provider Demographics
NPI:1144550468
Name:KAZEM PAYA MD. INC
Entity type:Organization
Organization Name:KAZEM PAYA MD. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:KAZEM
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYA
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:310-470-6570
Mailing Address - Street 1:1990 WESTWOOD BLVD
Mailing Address - Street 2:220
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4650
Mailing Address - Country:US
Mailing Address - Phone:310-470-6570
Mailing Address - Fax:310-470-8525
Practice Address - Street 1:1990 WESTWOOD BLVD
Practice Address - Street 2:220
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4650
Practice Address - Country:US
Practice Address - Phone:310-470-6570
Practice Address - Fax:310-470-8525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-08
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29425207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA29425Medicare PIN