Provider Demographics
NPI:1376763565
Name:MALAD, LAILA SHIRAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:LAILA
Middle Name:SHIRAZ
Last Name:MALAD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:31225 LA BAYA DRIVE,
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-6325
Mailing Address - Country:US
Mailing Address - Phone:818-865-8190
Mailing Address - Fax:818-735-9445
Practice Address - Street 1:31225 LA BAYA DR
Practice Address - Street 2:SUITE 205
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-4019
Practice Address - Country:US
Practice Address - Phone:818-865-8190
Practice Address - Fax:818-735-9445
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA344642084D0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB 50257Medicare UPIN