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General NPI Number Information
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NPI Number | 1194419390
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Entity Type | Individual
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Provider Name | CESAR AYALA DDS
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Gender | Male
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 12110 WOODSIDE AVE
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City | LAKESIDE
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State | CA
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Zip | 92040-3012
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Country | US
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Telephone | 619-334-8743
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Fax |
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Provider Business Mailing Address
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Address Line | 1724 METRO AVE APT 5309
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City | CHULA VISTA
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State | CA
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Zip | 91915-3274
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 108689
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License Number State | CA
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