Provider Demographics
NPI:1578854808
Name:ROY D AYALON, MD., INC
Entity Type:Organization
Organization Name:ROY D AYALON, MD., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB/GYN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:AYALON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-654-9312
Mailing Address - Street 1:18411 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3506
Mailing Address - Country:US
Mailing Address - Phone:818-654-9312
Mailing Address - Fax:818-654-9631
Practice Address - Street 1:18411 CLARK ST STE 107
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3530
Practice Address - Country:US
Practice Address - Phone:818-654-9312
Practice Address - Fax:818-654-9631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102319207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty