Provider Demographics
NPI:1396398822
Name:BITAR, AYAH (FNP - C)
Entity Type:Individual
Prefix:
First Name:AYAH
Middle Name:
Last Name:BITAR
Suffix:
Gender:F
Credentials:FNP - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 S DIAMOND BAR BLVD APT 118
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3486
Mailing Address - Country:US
Mailing Address - Phone:747-300-7102
Mailing Address - Fax:
Practice Address - Street 1:275 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3843
Practice Address - Country:US
Practice Address - Phone:714-516-9588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily