Provider Demographics
NPI:1497146120
Name:DASHTAEI, AYDA (DO)
Entity type:Individual
Prefix:
First Name:AYDA
Middle Name:
Last Name:DASHTAEI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 STARRY NIGHT DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4841
Mailing Address - Country:US
Mailing Address - Phone:858-207-8569
Mailing Address - Fax:
Practice Address - Street 1:15611 POMERADO RD STE 400
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:760-300-3647
Practice Address - Fax:858-207-0034
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A18093208600000X
390200000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty