Healthcare Provider Details

I. General information

NPI: 1225828072
Provider Name (Legal Business Name): HAYK LALAYAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40110 VICKER WAY
PALMDALE CA
93551-4866
US

IV. Provider business mailing address

40110 VICKER WAY
PALMDALE CA
93551-4866
US

V. Phone/Fax

Practice location:
  • Phone: 661-656-6007
  • Fax:
Mailing address:
  • Phone: 661-656-6007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberW9069344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: