Provider Demographics
NPI:1730626722
Name:AELA PAIZ DO INC
Entity type:Organization
Organization Name:AELA PAIZ DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB/GYN
Authorized Official - Prefix:DR
Authorized Official - First Name:AELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:323-599-0068
Mailing Address - Street 1:PO BOX 50567
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90050-0567
Mailing Address - Country:US
Mailing Address - Phone:323-599-0068
Mailing Address - Fax:
Practice Address - Street 1:9620 CLYBOURN AVE
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-1623
Practice Address - Country:US
Practice Address - Phone:323-599-0068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A11139Medicaid