Provider Demographics
NPI:1003948035
Name:SAVARIRAYAN, BAKTHAN (MD)
Entity Type:Individual
Prefix:
First Name:BAKTHAN
Middle Name:
Last Name:SAVARIRAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 W BALL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3702
Mailing Address - Country:US
Mailing Address - Phone:714-761-0332
Mailing Address - Fax:714-761-8792
Practice Address - Street 1:3356 W BALL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3702
Practice Address - Country:US
Practice Address - Phone:714-761-0332
Practice Address - Fax:714-761-8792
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26233208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ762832Medicaid
A87014,A25816Medicare UPIN
CAA87014,A25816Medicare UPIN
CAW2997Medicare ID - Type Unspecified