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NPI Code Detail

MEDICARE: DR. ABDUL WALI BAYAZ DDS

MEDICARE:  DR. ABDUL WALI BAYAZ  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry49469CA

General Provider Information

NPI Number : 1134134729
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ABDUL WALI BAYAZ DDS
Provider Business Mailing Address
First Line : 14435 HAMLIN ST STE 104
Second Line :
City : VAN NUYS
State : CA
Zip : 91401-6205
Country : US
Telephone Number : 818-781-0004
Fax Number : 818-787-0035
Provider Business Practice Location Address
First Line : 14435 HAMLIN ST STE 104
Second Line :
City : VAN NUYS
State : CA
Zip : 91401-6205
Country : US
Telephone Number : 818-781-0004
Fax Number : 818-787-0035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2006
Last Update Date : 04/24/2009

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Directions to “ DR. ABDUL WALI BAYAZ DDS” Practice Location

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