JUSTIN JAMES D DEVERA DO NPI 1104449362

NPI Information

Justin James D Devera, DO is a student in an organized health care education training program in San Diego, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Justin James D Devera, DO NPI is 1104449362. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

34800 BOB WILSON DR
BUILDING 3, INTERNAL MEDICINE
SAN DIEGO, CA
ZIP 92134
Phone: (619) 532-6827

The NPI 1104449362 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/22/2020 and was last updated on 7/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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