MEDICARE: ANIL DAYA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A49628	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CB217229	OTHER	CA	MEDICARE GROUP PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00A496280	OTHER	CA	BLUE SHIELD
3	A49628	OTHER	CA	PIN

General Provider Information

NPI Number	:	1770542722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL DAYA M.D.

Provider Business Mailing Address
First Line	:	32144 AGOURA RD STE 206
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4051
Country	:	US
Telephone Number	:	805-371-4820
Fax Number	:	805-371-4824

Provider Business Practice Location Address
First Line	:	1240 WESTLAKE BLVD
Second Line	:	SUITE 231
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-1929
Country	:	US
Telephone Number	:	805-446-4444
Fax Number	:	805-371-9239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	10/10/2017

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Directions to “ ANIL DAYA M.D.” Practice Location

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