Provider Demographics
NPI:1710934336
Name:VAID, NITI (DO, FACP)
Entity Type:Individual
Prefix:DR
First Name:NITI
Middle Name:
Last Name:VAID
Suffix:
Gender:F
Credentials:DO, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32144 AGOURA RD STE 118
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4046
Mailing Address - Country:US
Mailing Address - Phone:818-707-0290
Mailing Address - Fax:818-707-0291
Practice Address - Street 1:32144 AGOURA RD STE 118
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4046
Practice Address - Country:US
Practice Address - Phone:818-707-0290
Practice Address - Fax:818-707-0291
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8826207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI52507Medicare UPIN