Provider Demographics
NPI:1689849986
Name:ABRAHAM PAYKAR MD, INC
Entity Type:Organization
Organization Name:ABRAHAM PAYKAR MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-723-3131
Mailing Address - Street 1:1601 W AVENUE J STE 203
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2824
Mailing Address - Country:US
Mailing Address - Phone:661-723-3131
Mailing Address - Fax:661-723-3112
Practice Address - Street 1:1601 W AVENUE J STE 203
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2824
Practice Address - Country:US
Practice Address - Phone:661-723-3131
Practice Address - Fax:661-723-3112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54392207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF92167Medicare UPIN