Provider Demographics
NPI:1770542722
Name:DAYA, ANIL (MD)
Entity type:Individual
Prefix:
First Name:ANIL
Middle Name:
Last Name:DAYA
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 1:32144 AGOURA RD STE 206
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4051
Mailing Address - Country:US
Mailing Address - Phone:805-371-4820
Mailing Address - Fax:805-371-4824
Practice Address - Street 1:1240 WESTLAKE BLVD
Practice Address - Street 2:SUITE 231
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1929
Practice Address - Country:US
Practice Address - Phone:805-446-4444
Practice Address - Fax:805-371-9239
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49628207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A496280OtherBLUE SHIELD
CACB217229OtherMEDICARE GROUP PTAN
CAA49628OtherPIN
CAA49628OtherPIN
CA00A496280OtherBLUE SHIELD