Provider Demographics
NPI:1699295501
Name:AYOUB, FARHAN (MD)
Entity type:Individual
Prefix:
First Name:FARHAN
Middle Name:
Last Name:AYOUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 SAND CANYON AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3703
Mailing Address - Country:US
Mailing Address - Phone:949-791-3101
Mailing Address - Fax:
Practice Address - Street 1:16300 SAND CANYON AVE STE 311
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3703
Practice Address - Country:US
Practice Address - Phone:949-791-3101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10749500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine