Provider Demographics
NPI:1992926075
Name:AYOUBI, AHMAD SIAR (MD, MS)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:SIAR
Last Name:AYOUBI
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:510-886-3400
Mailing Address - Fax:510-506-7729
Practice Address - Street 1:20101 LAKE CHABOT RD FL 3
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546
Practice Address - Country:US
Practice Address - Phone:510-886-3400
Practice Address - Fax:510-506-7729
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA898468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA102267OtherSTATE MEDICAL LICENSE