Provider Demographics
NPI:1912380783
Name:NAYYAR, ANKUR (MD)
Entity Type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:NAYYAR
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 1:14901 RINALDI ST STE 325
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1235
Mailing Address - Country:US
Mailing Address - Phone:818-898-9898
Mailing Address - Fax:818-898-9899
Practice Address - Street 1:14901 RINALDI ST STE 325
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1235
Practice Address - Country:US
Practice Address - Phone:818-898-9898
Practice Address - Fax:818-898-9899
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1707752084N0400X
WAMD611854862084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA170775Medicaid
CAA170775OtherMEDI-CAL