Provider Demographics
NPI:1245495985
Name:GEORGE M. HAYTER, M.D. P.C.
Entity type:Organization
Organization Name:GEORGE M. HAYTER, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-513-3212
Mailing Address - Street 1:2101 E 4TH ST
Mailing Address - Street 2:#210A
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3814
Mailing Address - Country:US
Mailing Address - Phone:714-543-8832
Mailing Address - Fax:714-543-0360
Practice Address - Street 1:2101 E 4TH ST
Practice Address - Street 2:#210A
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3814
Practice Address - Country:US
Practice Address - Phone:714-543-8832
Practice Address - Fax:714-543-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC30849Medicare PIN