Provider Demographics
NPI:1568400885
Name:AYOUB, ELIAS I (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:I
Last Name:AYOUB
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 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-862-5160
Mailing Address - Fax:562-923-8205
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5010
Practice Address - Country:US
Practice Address - Phone:562-862-5160
Practice Address - Fax:562-923-8205
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39256207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG39256CMedicare PIN
CAW18865Medicare UPIN
CAWG39256BMedicare PIN