Provider Demographics
NPI:1558724963
Name:AYALA-RODRIGUEZ, IRVING (MD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:
Last Name:AYALA-RODRIGUEZ
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 1:2400 WIBLE RD STE 14
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-4734
Mailing Address - Country:US
Mailing Address - Phone:661-835-1240
Mailing Address - Fax:661-835-4667
Practice Address - Street 1:2400 WIBLE RD STE 14
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-4734
Practice Address - Country:US
Practice Address - Phone:661-835-1240
Practice Address - Fax:661-835-4667
Is Sole Proprietor?:No
Enumeration Date:2016-04-02
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA159093207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine