Provider Demographics
NPI:1740947720
Name:BEIT-AYVAZ, MYRNA PINEDA
Entity type:Individual
Prefix:MRS
First Name:MYRNA
Middle Name:PINEDA
Last Name:BEIT-AYVAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 INDIANA AVE STE 2606800
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4269
Mailing Address - Country:US
Mailing Address - Phone:951-782-0040
Mailing Address - Fax:
Practice Address - Street 1:6800 INDIANA AVE STE 260
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4287
Practice Address - Country:US
Practice Address - Phone:951-782-0040
Practice Address - Fax:951-782-2010
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator