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NPI Code Detail

MEDICARE: EDMUND AYOUB JR. MD

MEDICARE: EDMUND AYOUB JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA104389CA

General Provider Information

NPI Number : 1114180866
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDMUND AYOUB JR. MD
Provider Business Mailing Address
First Line : P O BOX 3282
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92263-3282
Country : US
Telephone Number : 760-327-9400
Fax Number : 760-327-9384
Provider Business Practice Location Address
First Line : 3655 E RAMON RD
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92264-1150
Country : US
Telephone Number : 760-327-9400
Fax Number : 760-327-9384
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2008
Last Update Date : 08/23/2022

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