Provider Demographics
NPI:1851376917
Name:KAYAL, ANAS (MD)
Entity Type:Individual
Prefix:
First Name:ANAS
Middle Name:
Last Name:KAYAL
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:PO BOX 511475
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-8030
Mailing Address - Country:US
Mailing Address - Phone:866-284-2771
Mailing Address - Fax:800-334-1041
Practice Address - Street 1:960 W SAN MARCOS BLVD STE 210
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1147
Practice Address - Country:US
Practice Address - Phone:760-707-6765
Practice Address - Fax:760-745-5016
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112450207RN0300X, 207RN0300X
MI4301079963207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA122332OtherNO. CALIFORNIA PTAN
CAA112450OtherCA LICENSE
CACB215259OtherSO. CALIFORNIA PTAN
WII32837Medicare UPIN