Individual
DR. PAIBOON MAHAISAVARIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8317 DAVIS STREET, SUITE A, DOWNEY, CA 90241-5021
(562) 869-1511
(562) 869-0771
Mailing address
8317 DAVIS STREET, SUITE A, DOWNEY, CA 90241-5021
(562) 869-1511
(562) 869-0771
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G66961
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G669610
—
CA
01
—
060068099
MEDICARE RAILROAD
CA
Enumeration date
12/19/2006
Last updated
08/19/2022
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