person
Justin James D Devera, DO
Student in an Organized Health Care Education/Training Program in San Diego, California
NPI 1104449362

Justin James D Devera is a Student in an Organized Health Care Education/Training Program based in Fpo, CA. Justin James D Devera practices in San Diego, CA and has the professional credentials of DO. The NPI Number for Justin James D Devera is 1104449362 and holds a License No. 0102206754 (California).

The current practice location address for Justin James D Devera is 34800 Bob Wilson Dr, San Diego, CA and can be reached out via phone at 619-532-6827.

Location: 34800 Bob Wilson Dr, San Diego, CA, 09588-6716
person
Provider Profile Details
NPI Number
1104449362
Provider Name
Justin James D Devera
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
34800 Bob Wilson Dr, San Diego, CA, 09588-6716
Phone Number
619-532-6827
Fax Number
Provider Enumeration Date
05/22/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104449362 05 MD
institution
Provider Business Practice Location Address Details
Address
34800 Bob Wilson Dr
City
State
Zip
92134
Phone Number
619-532-6827
Fax Number
person
Provider Business Mailing Address Details
Address
34800 Bob Wilson Dr
City
State
Zip
92134
Phone Number
619-532-6827
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
0102206754 (Virginia)
Definition
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.
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