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NPI Code Detail

MEDICARE: AVROK BIOSCIENCES, LLC

MEDICARE: AVROK BIOSCIENCES, LLC
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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1891468203
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVROK BIOSCIENCES, LLC
Provider Business Mailing Address
First Line : 1321 MOUNTAIN VIEW CIR
Second Line :
City : AZUSA
State : CA
Zip : 91702-1649
Country : US
Telephone Number : 818-280-8485
Fax Number :
Provider Business Practice Location Address
First Line : 1321 MOUNTAIN VIEW CIR
Second Line :
City : AZUSA
State : CA
Zip : 91702-1649
Country : US
Telephone Number : 818-280-8485
Fax Number :
Authorized Official
Title or Position : COO
Name : MR. JONATHAN MARTIN
Credential :
Telephone Number : 818-280-8485
Provider Enumeration Date : 07/30/2021
Last Update Date : 01/16/2023

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Directions to “AVROK BIOSCIENCES, LLC ” Practice Location

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