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General NPI Number Information
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NPI Number | 1255863841
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Entity Type | Individual
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Provider Name | JAFAR AYYAD MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2017
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 290 SPRUCE CT
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City | AZUSA
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State | CA
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Zip | 91702-1484
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Country | US
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Telephone | 626-483-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 2606 HOSPITAL BLVD SUITE B
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City | CORPUS CHRISTI
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State | TX
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Zip | 78405-1833
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Country | US
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Telephone | 361-902-4789
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Fax | 361-881-1467
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A166085
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License Number State | CA
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