Provider Demographics
NPI:1700405586
Name:KEYIAN PAYDAR, MD, PC
Entity Type:Organization
Organization Name:KEYIAN PAYDAR, MD, PC
Other - Org Name:PAYDAR PLASTIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYIAN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:PAYDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-307-0441
Mailing Address - Street 1:20 FAENZA
Mailing Address - Street 2:
Mailing Address - City:NEWPORT COAST
Mailing Address - State:CA
Mailing Address - Zip Code:92657-1601
Mailing Address - Country:US
Mailing Address - Phone:415-307-0441
Mailing Address - Fax:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty