1104072842 NPI number — DR. MIGUEL ANGEL GARCIA AYALA D.C.

Table of content: DR. MIGUEL ANGEL GARCIA AYALA D.C. (NPI 1104072842)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104072842 NPI number — DR. MIGUEL ANGEL GARCIA AYALA D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AYALA
Provider First Name:
MIGUEL ANGEL
Provider Middle Name:
GARCIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AYALA
Provider Other First Name:
MIKE
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1104072842
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
705 W LA VETA AVE
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
ORANGE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92868-4402
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-288-8886
Provider Business Mailing Address Fax Number:
714-288-9054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
705 W LA VETA AVE
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
ORANGE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92868-4402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-288-8886
Provider Business Practice Location Address Fax Number:
714-288-9054
Provider Enumeration Date:
08/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC28207 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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