Active NPI
Edmund Ayoub Jr., MD
- Family Medicine Physician
- Palm Springs, CA
National Provider Identifier
1114180866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A104389
- Practice address
- 3655 E Ramon Rd
Palm Springs, CA 92264-1150 - Phone
- (760) 327-9400
- Fax
- (760) 327-9384
- NPI assigned
- Jul 2, 2008
- Last updated
- Aug 23, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A104389 | CA | Primary |
Addresses
Primary practice location
3655 E Ramon Rd
Palm Springs, CA 92264-1150
Mailing address
P O Box 3282
Palm Springs, CA 92263-3282
Phone (760) 327-9400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A104389 | CA | MD | Family Medicine Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Palm Springs, CA
- NPI 1104089853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1114180866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 3282",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922633282",
"telephone_number": "760-327-9400",
"fax_number": "760-327-9384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3655 E RAMON RD",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "922641150",
"telephone_number": "760-327-9400",
"fax_number": "760-327-9384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AYOUB",
"first_name": "EDMUND",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-02",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A104389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.