Individual provider · Type 1 NPI
Michael Timothy Devereux, PA-C
Medical Physician Assistant · Sunol, CA
NPI number
1225217979
Active
Practice location
11925 Main St
Sunol, CA 94586-9490
Mailing address
PO Box 379
Sunol, CA 94586-0379
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA12220 (CA) |
Medical Physician Assistant: Definition to come...
About NPI 1225217979
Michael Timothy Devereux, PA-C's National Provider Identifier is 1225217979, issued on Oct 30, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Sunol, CA. The record was last updated on Jan 24, 2014.