Active NPI
Gino Joseph Aveni, PA
- Physician Assistant
- Harbor City, CA
National Provider Identifier
1609923226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA20784
- Practice address
- 25825 Vermont Ave
Harbor City, CA 90710-3518 - Phone
- (310) 517-2881
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA20784 | CA | Primary |
Addresses
Primary practice location
25825 Vermont Ave
Harbor City, CA 90710-3518
Mailing address
1246 E Maple Ave
El Segundo, CA 90245-3258
Phone (310) 322-2445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609923226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1246 E MAPLE AVE",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902453258",
"telephone_number": "310-322-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25825 VERMONT AVE",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "907103518",
"telephone_number": "310-517-2881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVENI",
"first_name": "GINO",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA20784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harbor City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.