Organization
AVANNET, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIRDRE ALLISON HABERMEHL MD (PRESIDENT)
(805) 603-3423
Entity
Organization
Contact information
Practice address
79 E DAILY DR STE 179, CAMARILLO, CA 93010-5807
(805) 603-3423
(805) 233-6636
Mailing address
79 E DAILY DR STE 179, CAMARILLO, CA 93010-5807
(805) 603-3423
(805) 233-6636
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G60299
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G60299
LICENSE NUMBER
CA
Enumeration date
10/02/2009
Last updated
10/02/2009
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