Healthcare Provider Details
I. General information
NPI: 1730626722
Provider Name (Legal Business Name): AELA PAIZ DO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2017
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9620 CLYBOURN AVE
SUN VALLEY CA
91352-1623
US
IV. Provider business mailing address
PO BOX 50567
LOS ANGELES CA
90050-0567
US
V. Phone/Fax
- Phone: 323-599-0068
- Fax:
- Phone: 323-599-0068
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AELA
PAIZ
Title or Position: OB/GYN
Credential: D.O
Phone: 323-599-0068