Individual
MR. MICHAEL TIMOTHY DEVEREUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11925 MAIN ST, SUNOL, CA 94586-9490
(925) 862-2130
Mailing address
PO BOX 379, SUNOL, CA 94586-0379
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA12220
CA
Other
Enumeration date
10/30/2007
Last updated
01/24/2014
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