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General NPI Number Information
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NPI Number | 1679865950
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Entity Type | Individual
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Provider Name | THOMAS JAMES AVALLONE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2011
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 1317 YNEZ PLACE
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City | CORONADO
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State | CA
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Zip | 92118
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Country | US
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Telephone | 619-435-8800
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Fax | 888-635-8108
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Provider Business Mailing Address
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Address Line | 671 B AVE
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City | CORONADO
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State | CA
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Zip | 92218
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | A147199
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A147199
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License Number State | CA
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