Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | A125020 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | A125020 | CA |
NPI | 1538459276 |
---|---|
Provider Name | Ajay Vaidya |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2011 |
Last Update Date | 28/08/2020 |