Individual
AVIS ETTA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3100 SAN PABLO AVE # 310, BERKELEY, CA 94702
(510) 985-5020
Mailing address
1450 TREAT BLVD # 300, WALNUT CREEK, CA 94597-2168
(925) 952-2888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G73867
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0028630
—
CA
05
—
ZZZ16371Z
—
CA
Enumeration date
02/09/2006
Last updated
07/02/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us