Organization
AVIISHA MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABRAHAM ISHAAYA M.D. (OWNER)
(323) 954-1788
Entity
Organization
Contact information
Practice address
415 ROLLING OAKS DR, SUITE 210, THOUSAND OAKS, CA 91361-1029
(323) 857-1682
Mailing address
5901 W OLYMPIC BLVD, SUITE 200, LOS ANGELES, CA 90036-4667
(323) 954-1788
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
859439
CA
207R00000X
Internal Medicine Physician
Primary
G71854
CA
207RP1001X
Pulmonary Disease Physician
G71854
CA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
G71854
CA
291U00000X
Clinical Medical Laboratory
G71854
CA
Other
Enumeration date
06/19/2009
Last updated
06/23/2009
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