Provider Demographics
NPI:1912465626
Name:IYER, GAYATHRI PARAMESWARAN
Entity Type:Individual
Prefix:
First Name:GAYATHRI
Middle Name:PARAMESWARAN
Last Name:IYER
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 1:1310 BARRY AVE
Mailing Address - Street 2:APT 101
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:424-371-4242
Mailing Address - Fax:
Practice Address - Street 1:UNITED HEALTH CENTERS, 121 BARBOZA ST
Practice Address - Street 2:
Practice Address - City:MENDOTA
Practice Address - State:CA
Practice Address - Zip Code:93640
Practice Address - Country:US
Practice Address - Phone:559-655-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1035791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice