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NPI Code Detail

MEDICARE: CHRISTIAN DEVERAUX DO

MEDICARE: CHRISTIAN DEVERAUX DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianDR.0075634CO
2390200000XStudent in an Organized Health Care Education/Training Program
3207P00000XEmergency Medicine Physician21815CA

General Provider Information

NPI Number : 1497497895
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN DEVERAUX DO
Provider Business Mailing Address
First Line : 1303 E HERNDON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-3309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1303 E HERNDON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-3309
Country : US
Telephone Number : 559-450-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2022
Last Update Date : 06/05/2026

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Directions to “ CHRISTIAN DEVERAUX DO” Practice Location

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