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Individual

VLADISLAV DAVID AVETISOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
1501 SKYLINE DR, MONTEREY, CA 93940-4110
(831) 373-3716
Mailing address
4685 TALLYHO DR, SACRAMENTO, CA 95826-5544
(916) 307-3459

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
304751
CA

Other

Enumeration date
08/29/2023
Last updated
08/29/2023
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