Basic Information
| Provider Information | |||||||||
| NPI: | 1447695325 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IYER | ||||||||
| FirstName: | ADITYA | ||||||||
| MiddleName: | KRISHNA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2020 SANTA MONICA BLVD FL 3 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904042023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108298868 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11550 INDIAN HILLS RD STE 261 | ||||||||
| Address2: | |||||||||
| City: | MISSION HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913451244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188476570 | ||||||||
| FaxNumber: | 3105827495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2013 | ||||||||
| LastUpdateDate: | 12/21/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085N0700X | A131842 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 207T00000X | A131842 | CA | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.