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General NPI Number Information
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NPI Number | 1710779525
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Entity Type | Individual
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Provider Name | MRS. DARYA KHOUDOIAR
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Gender | Female
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 4300 ROSE DR
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City | YORBA LINDA
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State | CA
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Zip | 92886-2026
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Country | US
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Telephone | 714-577-6680
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Fax |
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Provider Business Mailing Address
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Address Line | 5542 E VISTA DEL DIA
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City | ANAHEIM
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State | CA
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Zip | 92807-3844
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Country | US
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Telephone | 818-317-7270
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 783215
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License Number State | CA
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