Individual provider Active NPI

William G. Ayoub, D.P.M.

  • Podiatrist
  • San Dimas, CA
National Provider Identifier
1639137425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2308 Issued in CA
Practice address
425 W Bonita Ave Ste 110
San Dimas, CA 91773-2543
Phone
(909) 599-0981
Fax
(909) 592-0738
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2308 CA Primary

Addresses

Primary practice location

425 W Bonita Ave Ste 110
San Dimas, CA 91773-2543

Mailing address

425 W Bonita Ave Ste 110
San Dimas, CA 91773-2543
Phone (909) 599-0981

Other identifiers 3

IdentifierTypeStateIssuer
000E23080MedicaidCA
000E23081MedicaidCA
000E23082MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639137425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W BONITA AVE STE 110",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732543",
            "telephone_number": "909-599-0981",
            "fax_number": "909-592-0738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W BONITA AVE STE 110",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732543",
            "telephone_number": "909-599-0981",
            "fax_number": "909-592-0738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "WILLIAM",
        "middle_name": "G.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E23080",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E23081",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E23082",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.