Asha Devereaux, MD, Mph A Professional Corporation
Specialist in Coronado, CA. Organization (NPI-2).
NPI number1053597641
StatusActive
Last updated in NPPESOct 18, 2019
Details
- NPI
- 1053597641
- Entity type
- Organization (NPI-2)
- Legal business name
- Asha Devereaux, MD, Mph A Professional Corporation
- Organization subpart
- No
- Enumeration date
- Jan 14, 2008
- Last updated
- Oct 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | A51614 | CA | Yes |
Practice location
1224 10th StSte 205
Coronado, CA 92118-3416
Phone 619-435-4203
Mailing address
1224 10th StSte 205
Coronado, CA 92118-3416
Phone 619-435-4203
Authorized official
Asha V Devereaux
President
6194354203
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