Provider Demographics
NPI:1891993168
Name:AYROSO, VINCENT VALINO (DO)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:VALINO
Last Name:AYROSO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24101 HIGH KNOB RD
Mailing Address - Street 2:C
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4263
Mailing Address - Country:US
Mailing Address - Phone:562-228-6645
Mailing Address - Fax:
Practice Address - Street 1:12751 HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5800
Practice Address - Country:US
Practice Address - Phone:714-636-7852
Practice Address - Fax:714-636-0928
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine