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General NPI Number Information
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NPI Number | 1720353162
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Entity Type | Organization
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Legal Business Name | USHA P IYER M D INC
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Dates
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Enumeration Date | 03/19/2012
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 1211 W LA PALMA AVE SUITE 503
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City | ANAHEIM
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State | CA
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Zip | 92801-2815
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Country | US
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Telephone | 714-533-1703
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Fax | 714-533-0761
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Provider Business Mailing Address
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Address Line | 1211 W LA PALMA AVE SUITE 503
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City | ANAHEIM
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State | CA
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Zip | 92801-2815
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Country | US
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Telephone | 714-533-1703
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Fax | 714-533-0761
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Authorized Official
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Title or Position | PRESIDENT
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Name | USHA P IYER
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Credential | M.D
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Telephone | 714-533-0745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A26682
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License Number State | CA
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