Healthcare Provider Details

I. General information

NPI: 1801759188
Provider Name (Legal Business Name): TRUHEALTH MEDCO GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10906 RIVERSIDE DR UNIT A
NORTH HOLLYWOOD CA
91602
US

IV. Provider business mailing address

10906 RIVERSIDE DR UNIT A
NORTH HOLLYWOOD CA
91602
US

V. Phone/Fax

Practice location:
  • Phone: 818-722-3336
  • Fax:
Mailing address:
  • Phone: 818-722-3336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL AYALA
Title or Position: CEO/OWNER
Credential: MD
Phone: 818-722-3336