Avaocado Medical Group

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

G50213 Issued in CA

Legal business name

AVAOCADO MEDICAL GROUP

Practice address

1441 Avocado Ave
702
Newport Beach, CA 92660-7721

Phone

(949) 720-9266

NPI assigned

Oct 16, 2009

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Part of

Tri - State Medical Group Inc

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John D Homan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Huntington Beach, CA
  • NPI 1437116142
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1932434438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8941 ATLANTA AVE # 522",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926467121",
            "telephone_number": "714-299-2666",
            "fax_number": "949-438-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE",
            "address_2": "702",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607721",
            "telephone_number": "949-720-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVAOCADO MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-10-16",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "G50213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuri Ausker
• Bonnie Michelle Austin, P.T.
• Mitchell Clyde Austin, MD
• Autism Solutions for Kids, Inc
• Avalon Medical Associates Incorporated
• Joanna Avery, MS, RDN, CDCES
• Nick Avetoom, DDS
• Rebecca I Avila
• Maria Karina Avilez
• John L Avitabile, LMFT

• Non-Pharmacy Dispensing Site in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.