Provider Demographics
NPI:1497773287
Name:HOUSHAN, IYAD G (MD)
Entity Type:Individual
Prefix:DR
First Name:IYAD
Middle Name:G
Last Name:HOUSHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3401 W SUNFLOWER AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6948
Mailing Address - Country:US
Mailing Address - Phone:714-619-8777
Mailing Address - Fax:800-224-9751
Practice Address - Street 1:3401 W SUNFLOWER AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6948
Practice Address - Country:US
Practice Address - Phone:714-619-8777
Practice Address - Fax:800-224-9751
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCS10067OtherPHARMACY
NV10568OtherNV LICENSE
NVBH7090020OtherDEA
NV10568OtherNV LICENSE
NVH87279Medicare UPIN