Individual
JUSTIN JAMES D DEVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
34800 BOB WILSON DR, BUILDING 3, INTERNAL MEDICINE, SAN DIEGO, CA 92134
(619) 532-6827
Mailing address
UNIT 100267 BOX 1663, FPO, AE 09588-6716
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0102206754
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104449362
—
MD
Enumeration date
05/22/2020
Last updated
05/01/2025
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