James Lester Avery, P.A.
Physician Assistant in Stockton, CA. Individual provider (NPI-1).
NPI number1790080182
StatusActive
Last updated in NPPESNov 19, 2015
Details
- NPI
- 1790080182
- Entity type
- Individual (NPI-1)
- Name
- James Lester Avery
- Credential
- P.A.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 17, 2011
- Last updated
- Nov 19, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA20054 | CA | Yes |
| 363L00000X | Nurse Practitioner | 20641 | CA |
Practice location
1801 E March LnD-460
Stockton, CA 95210-6629
Phone 209-472-2300
Mailing address
Po Box 1364Manteca, CA 95336-1146
Phone 209-262-8386
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