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Organization
AVAOCADO MEDICAL GROUP
Active
Organization
AVAOCADO MEDICAL GROUP
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
1441 AVOCADO AVE, 702, NEWPORT BEACH, CA 92660-7721
(949) 720-9266
Mailing address
8941 ATLANTA AVE # 522, HUNTINGTON BEACH, CA 92646-7121
(714) 299-2666
(949) 438-3868
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G50213
CA
Other
Enumeration date
10/16/2009
Last updated
09/01/2020
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