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General NPI Number Information
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NPI Number | 1033402326
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Entity Type | Organization
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Legal Business Name | JAMES R VEVAINA MD PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 8929 UNIVERSITY CENTER LN SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92122-1006
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Country | US
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Telephone | 858-581-0400
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Fax | 858-581-0070
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Provider Business Mailing Address
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Address Line | 8929 UNIVERSITY CENTER LN SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92122-1006
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Country | US
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Telephone | 858-581-0400
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Fax | 858-581-0070
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Authorized Official
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Title or Position | OWNER
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Name | JAMES R VEVAINA
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Credential | MD
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Telephone | 858-581-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A30551
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License Number State | CA
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