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General NPI Number Information
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NPI Number | 1689992489
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Entity Type | Individual
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Provider Name | NEIL MAHESH VYAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 2005 BAY ST SUITE 201
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City | TAUNTON
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State | MA
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Zip | 02780-1085
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Country | US
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Telephone | 508-823-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 13652 CANTARA ST. PANORAMA CITY MOB #2
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City | PANORAMA CITY
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State | CA
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Zip | 91402
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A130645
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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