Provider Demographics
NPI:1568664977
Name:GEORGE, JAYA ANNA (MD,)
Entity Type:Individual
Prefix:DR
First Name:JAYA
Middle Name:ANNA
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:JAYA
Other - Middle Name:ANNA
Other - Last Name:GEORGE-FERNANDEZ ZAVALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5405 ALTON PARKWAY
Mailing Address - Street 2:787
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604
Mailing Address - Country:US
Mailing Address - Phone:626-224-4282
Mailing Address - Fax:714-772-6493
Practice Address - Street 1:1211 W LA PALMA AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-2815
Practice Address - Country:US
Practice Address - Phone:714-772-8282
Practice Address - Fax:714-772-6493
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94897207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A384130Medicaid
CABG9764362OtherDEA NUMBER
CAWA94897AMedicare PIN