Provider Demographics
NPI:1902835416
Name:BAYDUR, AHMET (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMET
Middle Name:
Last Name:BAYDUR
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 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-1309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:323-442-5641
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20722207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356390009OtherGROUP NPI
CAW18762OtherGROUP MEDICARE PIN
CAW11675OtherGROUP MEDICARE
CA11G207220197OtherCAL OPTIMA
CACE1617OtherGROUP RAILROAD MEDICARE
CAGR0100430OtherGROUP MEDICAL
CA00G207220OtherBLUE SHIELD
CAGROO16910OtherGROUP MEDICAID PIN
CAP00270978OtherRAILROAD MEDICARE
CA00G207220Medicaid
CA1902846306OtherGROUP NPI
CA00G207220Medicaid
CA00G207220OtherBLUE SHIELD
CA11G207220197OtherCAL OPTIMA