Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A53397 | CA |
N | 2081P2900X | Pain Medicine | A53397 | CA |
N | 208D00000X | General Practice Physician | A53397 | CA |
NPI | 1356451579 |
---|---|
Provider Name | Ziyad Ayyoub |
First Address | City Of Industry, CA 91715-0936 |
Second Address | Downey, CA 90242-3456 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G81939 | (02) | CA |