Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 30620 | CA |
NPI | 1063641256 |
---|---|
Provider Name | Dr. Gary L Devian |
First Address | Yorba Linda, CA 92886-3810 |
Second Address | Yorba Linda, CA 92886-3810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2009 |
Last Update Date | 08/07/2009 |