# AVIDA HEALTH SYSTEMS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265170765
- **Authorized official:** MR. JURO CHRIST ENRIQUEZ ADEFUIN (CEO)
- **Authorized official phone:** (562) 552-7775

## Contact information

- **Practice address:** 222 N MOUNTAIN AVE STE 205, UPLAND, CA 91786-5714
- **Practice address phone:** (909) 333-7133
- **Practice address fax:** (909) 236-7989
- **Mailing address:** 222 N MOUNTAIN AVE STE 205, UPLAND, CA 91786-5714
- **Mailing address phone:** (909) 333-7133
- **Mailing address fax:** (909) 236-7989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2022
- **Last updated:** 05/24/2022