Provider Demographics
NPI:1841454758
Name:ALAYO, ERICK H (MD)
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:H
Last Name:ALAYO
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 1:353A CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-3906
Mailing Address - Country:US
Mailing Address - Phone:619-585-8883
Mailing Address - Fax:619-585-0166
Practice Address - Street 1:587 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5619
Practice Address - Country:US
Practice Address - Phone:619-382-3315
Practice Address - Fax:619-585-0166
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2023-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
IL036-113338207R00000X
CAA107506207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACD720Medicare PIN
I46600Medicare UPIN