Individual
DR. ABHAY MAKARAND VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 S MOORPARK RD, THOUSAND OAKS, CA 91361-1008
(805) 379-9646
(805) 379-0611
Mailing address
301 S MOORPARK RD, THOUSAND OAKS, CA 91361-1008
(805) 379-9646
(805) 379-0611
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G86471
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G86471
LICENSE
CA
01
—
P00957559
MEDICARE RAILROAD
CA
Enumeration date
08/01/2006
Last updated
11/07/2011
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