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General NPI Number Information
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NPI Number | 1346250347
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Entity Type | Organization
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Legal Business Name | AVALON MEDICAL DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 100 FALLS CANYON ROAD
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City | AVALON
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State | CA
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Zip | 90704-1563
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Country | US
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Telephone | 310-510-0700
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Fax | 310-510-2938
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Provider Business Mailing Address
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Address Line | P.O. BOX 1563
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City | AVALON
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State | CA
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Zip | 90704-1563
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Country | US
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Telephone | 310-510-0700
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Fax | 310-510-2938
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Authorized Official
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Title or Position | CEO
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Name | MR. JASON D PARET
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Credential |
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Telephone | 310-510-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | 930000010
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 930000010
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 930000010
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 930000010
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License Number State | CA
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