MEDICARE: TRUHEALTH MEDCO GROUP INC

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
1	207QA0505X	Adult Medicine Physician

General Provider Information

NPI Number	:	1801759188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUHEALTH MEDCO GROUP INC

Provider Business Mailing Address
First Line	:	10906 RIVERSIDE DR
Second Line	:	UNIT A
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602
Country	:	US
Telephone Number	:	818-722-3336
Fax Number	:

Provider Business Practice Location Address
First Line	:	10906 RIVERSIDE DR
Second Line	:	UNIT A
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602
Country	:	US
Telephone Number	:	818-722-3336
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DANIEL AYALA
Credential	:	MD
Telephone Number	:	818-722-3336

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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