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NPI Code Detail

MEDICARE: MR. BRYAN AVINA

MEDICARE: MR. BRYAN AVINA
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1609409069
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRYAN AVINA
Provider Business Mailing Address
First Line : 2310 1ST ST
Second Line :
City : NAPA
State : CA
Zip : 94559-2239
Country : US
Telephone Number : 707-224-8266
Fax Number :
Provider Business Practice Location Address
First Line : 2310 1ST ST
Second Line :
City : NAPA
State : CA
Zip : 94559-2239
Country : US
Telephone Number : 707-224-8266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2020
Last Update Date : 01/07/2026

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Directions to “ MR. BRYAN AVINA ” Practice Location

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