Healthcare Provider Details

I. General information

NPI: 1093322372
Provider Name (Legal Business Name): AYAK TIOP OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WINDY POINT DR
SAN MARCOS CA
92069-1701
US

IV. Provider business mailing address

700 WINDY POINT DR
SAN MARCOS CA
92069-1701
US

V. Phone/Fax

Practice location:
  • Phone: 800-241-1027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: