Provider Demographics
NPI:1861553992
Name:LAYYOUS, MAI M (LAC, OMD)
Entity type:Individual
Prefix:MRS
First Name:MAI
Middle Name:M
Last Name:LAYYOUS
Suffix:
Gender:F
Credentials:LAC, OMD
Other - Prefix:MRS
Other - First Name:MAI
Other - Middle Name:M
Other - Last Name:LAYYOUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, OMD
Mailing Address - Street 1:885 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4135
Mailing Address - Country:US
Mailing Address - Phone:714-928-6307
Mailing Address - Fax:714-776-6307
Practice Address - Street 1:1741 W ROMNEYA DR
Practice Address - Street 2:SUITE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1805
Practice Address - Country:US
Practice Address - Phone:714-928-6307
Practice Address - Fax:714-776-3678
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC 8335171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist