Provider Demographics
NPI:1710026067
Name:Z AYYOUB MEDICAL GROUP INC
Entity Type:Organization
Organization Name:Z AYYOUB MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZIYAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYYOUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-633-0976
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:562-401-6247
Practice Address - Street 1:16660 PARAMOUNT BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5433
Practice Address - Country:US
Practice Address - Phone:562-633-0976
Practice Address - Fax:562-401-6247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53397261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356451579OtherNPI
CA00A533970Medicaid
CA00A533970Medicaid
CAJ81939Medicare UPIN