Individual provider · NPI-1

Sergio Nathaniel Avila, PA-C

Physician Assistant · Pomona, CA

NPI number1396405312
StatusActive
Last updated in NPPESMay 12, 2026

Details

NPI
1396405312
Entity type
Individual (NPI-1)
Name
Sergio Nathaniel Avila
Credential
PA-C
Sex
Male
Sole proprietor
No
Enumeration date
Dec 20, 2021
Certification date
May 12, 2026
Last updated
May 12, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA60689CAYes

Practice location

790 E Bonita Ave Fl 2
Pomona, CA 91767-1906

Phone 909-447-8585 · Fax 909-447-8593

Mailing address

840 Towne Center Dr
Pomona, CA 91767-5900

Phone 909-398-1550 · Fax 909-398-0128

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