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ANDREW AVERITT
>> Organized Health Care Education/Training Program >> StudentRegistrant NPI Number: 1356878698
Individual Registrant: ANDREW AVERITT
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
200 MERCY CIRCLE NAVAL HOSPITAL CAMP PENDLETON BOX 555191 CAMP PENDLETON, CA 92055 US
Tel: 760-719-3675 Fax: --
Tel: 760-719-3675 Fax: --
Contact information for business:
200 MERCY CIRCLE NAVAL HOSPITAL CAMP PENDLETON BOX 555191 CAMP PENDLETON, CA 92055 US
Tel: 760-719-3675 Fax: --
Tel: 760-719-3675 Fax: --
Registration Information:
NPI: 1356878698
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 390200000X | Student Organized Health Care Education/Training Program | CA |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
