Provider Information for 1629467915
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CELIA AVILA
Sex: Female
NPI: 1629467915
Last Updated: 2025-01-22
Certification Date: 2025-01-22
Certification Date: 2025-01-22
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1629467915 | ||||||||||||||
| Enumeration Date | 2015-01-09 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | PO BOX 951 BALDWIN PARK, CA 91706-0951 United States Phone: 909-620-2521 | Fax: | ||||||||||||||
| Primary Practice Address | 21520 PIONEER BLVD SUITE 110 HAWAIIAN GARDENS, CA 90716-2603 United States Phone: 562-865-3644 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 1511 W GARVEY AVE N | ||||||||||||||
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