| Avannet, Inc. | |
|
79 E Daily Dr Ste 179 Camarillo CA 93010-5807 | |
| (805) 603-3423 | |
| (805) 233-6636 |
| Full Name | Avannet, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 79 E Daily Dr Ste 179, Camarillo, California |
| Authorized Official Name and Position | Deirdre Allison Habermehl (PRESIDENT) |
| Authorized Official Contact | 8056033423 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avannet, Inc. 79 E Daily Dr Ste 179 Camarillo CA 93010-5807 Ph: (805) 603-3423 | Avannet, Inc. 79 E Daily Dr Ste 179 Camarillo CA 93010-5807 Ph: (805) 603-3423 |
| NPI Number | 1568797967 |
|---|---|
| Provider Enumeration Date | 10/02/2009 |
| Last Update Date | 10/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568797967 | NPI | - | NPPES |
| G60299 | Other | CA | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | G60299 (California) | Primary |
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