Healthcare Provider Details

I. General information

NPI: 1861196248
Provider Name (Legal Business Name): AVATION MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27451 TOURNEY RD STE 100
VALENCIA CA
91355-6301
US

IV. Provider business mailing address

PO BOX 736474
CHICAGO IL
60673-6474
US

V. Phone/Fax

Practice location:
  • Phone: 888-972-5694
  • Fax:
Mailing address:
  • Phone: 888-972-5694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MANISH VAISHYA
Title or Position: CEO
Credential:
Phone: 661-904-3891