Provider Demographics
NPI:1578681573
Name:PAYDAR, KEYIAN Z (MD)
Entity Type:Individual
Prefix:
First Name:KEYIAN
Middle Name:Z
Last Name:PAYDAR
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 1:1401 AVOCADO AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8729
Mailing Address - Country:US
Mailing Address - Phone:949-755-0575
Mailing Address - Fax:949-755-0580
Practice Address - Street 1:1401 AVOCADO AVE STE 301
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8729
Practice Address - Country:US
Practice Address - Phone:949-755-0575
Practice Address - Fax:949-755-0580
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74742208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery