Dr. Ayala grew up in Texas. He majored in Biochemistry at the University of Texas at San Antonio, then received his medical degree through New York Medical College’s Fifth Pathway program and the University of Montemorelos in Montemorelos, Mexico. After medical school, he moved to Fresno to join the UCSF-Fresno Family and Community Medicine Residency program, where he was Chief Resident. Dr. Ayala is a family physician in Hanford and in Selma (Fresno County), a farming community where most residents are on Medi-Cal and there is a major shortage of doctors. He is Chief Medical Officer of the Adventist Health Central Valley Rural Health System, where he helped launch a Complex Chronic Care clinic in order to streamline hospital discharges, reduce re-admissions, and help establish patients with primary care medical homes throughout Adventist’s network of 27 clinics. Dr. Ayala also organizes an annual symposium for Central Valley doctors specializing in clinical updates for primary care and substance abuse.