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Individual

CARLOS XAVIER AYON MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
41715 WINCHESTER RD, TEMECULA, CA 92590-4808
(760) 737-6960
Mailing address
425 N DATE ST, ESCONDIDO, CA 92025-3413
(760) 737-6960

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A114419
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FA429Z
MEDICARE PTAN
CA
01
W14158
MEDICARE GROUP PTAN
CA
01
ZZZ20041Z
GROUP PTAN
CA
Enumeration date
06/30/2008
Last updated
06/20/2013
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