Healthcare Provider Details

I. General information

NPI: 1013560887
Provider Name (Legal Business Name): YVORN ASWAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 AVALON BLVD
LOS ANGELES CA
90011-5622
US

IV. Provider business mailing address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

V. Phone/Fax

Practice location:
  • Phone: 323-582-2251
  • Fax:
Mailing address:
  • Phone: 401-444-3762
  • Fax: 401-444-8879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD20109
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: