Individual
GINA AVILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
536 W VISTA WAY STE A, VISTA, CA 92083-5704
(760) 758-1650
Mailing address
9808 VENICE BLVD STE 700, CULVER CITY, CA 90232-6824
(310) 945-3350
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/01/2024
Last updated
11/01/2024
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