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DR. AVI J HETTENA M.D.

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1013029487

Individual Registrant:
DR. AVI J HETTENA M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
6037 LA GRANADA, SUITE C  RANCHO SANTA FE, CA 92067 US
Tel: 858-756-2116  Fax: 858-400-5113

Contact information for business:
PO BOX 7281  RANCHO SANTA FE, CA 92067-7281 US
Tel: 518-637-8637  Fax: 415-358-4754

Registration Information:
NPI: 1013029487
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
CAG45263
Y207RN0300XAllopathic & Osteopathic Physicians
Internal Medicine
CAG45263

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00G452630CA05
MEDICARE RAILROAD110017611CA01




HEALTH CARE JOBS CA - Page 1



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