Individual
DR. MARCO ANTONIO AYULO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17100 EUCLID ST, FOUNTAIN VALLEY, CA 92708-4004
(714) 966-7253
Mailing address
305 2ND ST, HERMOSA BEACH, CA 90254-4662
(718) 801-1594
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A116669
CA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
A116669
CA
Other
Enumeration date
05/05/2011
Last updated
06/18/2013
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