Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist | 017877 | CA |
Y | 156FC0800X | Contact Lens |
NPI | 1326340845 |
---|---|
Provider Name | Aeven Amir Awraha |
First Address | El Cajon, CA 92020-4008 |
Second Address | El Cajon, CA 92020-4008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2010 |
Last Update Date | 04/12/2010 |