Provider Demographics
NPI:1942279633
Name:VYAS, MAHESHKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHESHKUMAR
Middle Name:
Last Name:VYAS
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 1:8245 E MONTE VISTA RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92808-3748
Mailing Address - Country:US
Mailing Address - Phone:714-974-0100
Mailing Address - Fax:714-974-0300
Practice Address - Street 1:8245 E MONTE VISTA RD STE 200
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-1297
Practice Address - Country:US
Practice Address - Phone:714-974-0100
Practice Address - Fax:714-974-0300
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39509208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA39509AMedicare PIN
CAA39509Medicare UPIN