Provider Demographics
NPI:1265573521
Name:NAYAB, LAILA MUVSHIDI (DC)
Entity type:Individual
Prefix:
First Name:LAILA
Middle Name:MUVSHIDI
Last Name:NAYAB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92781
Mailing Address - Country:US
Mailing Address - Phone:714-832-1212
Mailing Address - Fax:714-832-1221
Practice Address - Street 1:210 W. MAIN ST #104
Practice Address - Street 2:SUITE 104
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780
Practice Address - Country:US
Practice Address - Phone:714-832-1212
Practice Address - Fax:714-832-1221
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor