Individual provider · Type 1 NPI
Gregory Avetisov, DO
General Practice Physician · Lincoln, CA
NPI number
1679917280
Active
Practice location
2641 Miller Run Ln
Lincoln, CA 95648-7545
Mailing address
PO Box 939
Angels Camp, CA 95222-0939
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 17139 (FL) |
| General Practice Physician Primary | 208D00000X | 20A22510 (CA) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Other general practice physician providers in Lincoln
About NPI 1679917280
Gregory Avetisov, DO's National Provider Identifier is 1679917280, issued on Apr 25, 2013. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Lincoln, CA. The record was last updated on Jun 1, 2026.