Provider Demographics
NPI:1992367304
Name:TYLER, RAYON
Entity Type:Individual
Prefix:
First Name:RAYON
Middle Name:
Last Name:TYLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9122 HALL RD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5307
Mailing Address - Country:US
Mailing Address - Phone:562-445-0023
Mailing Address - Fax:757-788-8636
Practice Address - Street 1:9122 HALL RD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5307
Practice Address - Country:US
Practice Address - Phone:562-445-0023
Practice Address - Fax:757-788-8636
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health