Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E1275 | CA |
N | 213ES0131X | Foot Surgery | E1275 | CA |
NPI | 1346482445 |
---|---|
Provider Name | Dr. Joseph Anthony Averna |
First Address | San Diego, CA 92103 |
Second Address | San Diego, CA 92103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2009 |
Last Update Date | 03/04/2009 |