Provider Demographics
NPI:1356451579
Name:AYYOUB, ZIYAD (MD)
Entity Type:Individual
Prefix:
First Name:ZIYAD
Middle Name:
Last Name:AYYOUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90936
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91715-0936
Mailing Address - Country:US
Mailing Address - Phone:562-633-0976
Mailing Address - Fax:562-633-8470
Practice Address - Street 1:16660 PARAMOUNT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5457
Practice Address - Country:US
Practice Address - Phone:562-633-0976
Practice Address - Fax:562-633-8470
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA533972081P0004X, 2081P2900X, 208D00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA53397AMedicare ID - Type UnspecifiedPPIN
CAG81939Medicare UPIN