MEDICARE: ANKUR NAYYAR M.D.

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
1	2084N0400X	Neurology Physician	A170775	CA
2	2084N0400X	Neurology Physician	MD61185486	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A170775	OTHER	CA	MEDI-CAL

General Provider Information

NPI Number	:	1912380783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANKUR NAYYAR M.D.

Provider Business Mailing Address
First Line	:	14901 RINALDI ST STE 325
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1235
Country	:	US
Telephone Number	:	818-898-9898
Fax Number	:	818-898-9899

Provider Business Practice Location Address
First Line	:	14901 RINALDI ST STE 325
Second Line	:
City	:	MISSION HILLS
State	:	CA
Zip	:	91345-1235
Country	:	US
Telephone Number	:	818-898-9898
Fax Number	:	818-898-9899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	10/17/2023

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