Basic Information
Provider Information | |||||||||
NPI: | 1801207014 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | AIYER | ||||||||
FirstName: | ROHIT | ||||||||
MiddleName: | SANJEEV | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 140 E COMMONWEALTH AVE STE 101 | ||||||||
Address2: |   | ||||||||
City: | FULLERTON | ||||||||
State: | CA | ||||||||
PostalCode: | 928321905 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7147734111 | ||||||||
FaxNumber: | 7147734222 | ||||||||
Practice Location | |||||||||
Address1: | 140 E COMMONWEALTH AVE STE 101 | ||||||||
Address2: |   | ||||||||
City: | FULLERTON | ||||||||
State: | CA | ||||||||
PostalCode: | 928321905 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7147734111 | ||||||||
FaxNumber: | 7147734222 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/12/2014 | ||||||||
LastUpdateDate: | 09/20/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 09/20/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P2900X | 29176701 | NY | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Pain Medicine | 2084P2900X | 4301116655 | MI | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Pain Medicine | 2084P0800X | A176800 | CA | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 207LP2900X | 291767-01 | NY | N |   | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | 4301116655 | MI | N |   | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | A176800 | CA | N |   | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 2084P0800X | 291767-01 | NY | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P2900X | A176800 | CA | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Pain Medicine |
No ID Information.