Organization
ASHA DEVEREAUX, MD, MPH A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHA V DEVEREAUX MD (PRESIDENT)
(619) 435-4203
Entity
Organization
Contact information
Practice address
1224 10TH ST, STE 205, CORONADO, CA 92118-3416
(619) 435-4203
Mailing address
1224 10TH ST, STE 205, CORONADO, CA 92118-3416
(619) 435-4203
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A51614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A516140
—
CA
Enumeration date
01/14/2008
Last updated
10/18/2019
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