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NPI Code Detail

MEDICARE: JENNIFER AVILES

MEDICARE:   JENNIFER  AVILES
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1821408808
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER AVILES
Provider Business Mailing Address
First Line : 1933 S BROADWAY FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-4501
Country : US
Telephone Number : 213-259-4408
Fax Number :
Provider Business Practice Location Address
First Line : 1933 S BROADWAY FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-4501
Country : US
Telephone Number : 213-259-4408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2014
Last Update Date : 06/16/2023

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Directions to “ JENNIFER AVILES ” Practice Location

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