Organization
ROBERT A. DEVEREAUX, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ALLAN DEVEREAUX M.D. (PRESIDENT)
(714) 957-9389
Entity
Organization
Contact information
Practice address
11100 WARNER AVE, SUITE 100, FOUNTAIN VALLEY, CA 92708-7506
(714) 957-9389
(714) 957-0144
Mailing address
11100 WARNER AVE, SUITE 100, FOUNTAIN VALLEY, CA 92708-7506
(714) 957-9389
(714) 957-0144
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A31475
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A314750
—
CA
Enumeration date
01/02/2008
Last updated
02/06/2008
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