Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A167088 | CA |
Y | 111NI0900X | Internist | A167088 | CA |
NPI | 1003340423 |
---|---|
Provider Name | Allen Avedian |
First Address | Templeton, CA 93465-4003 |
Second Address | Templeton, CA 93465-4003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2017 |
Last Update Date | 27/10/2020 |