Healthcare Provider Details

I. General information

NPI: 1346812385
Provider Name (Legal Business Name): PRECISION MEDICAL THERAPEUTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2021
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2070 CENTURY PARK E
LOS ANGELES CA
90067-1907
US

IV. Provider business mailing address

312 S BEVERLY DR UNIT 3184
BEVERLY HILLS CA
90212-1953
US

V. Phone/Fax

Practice location:
  • Phone: 424-522-7100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PIYUSH P NAYYAR
Title or Position: PRESIDENT
Credential: MD
Phone: 424-305-0153