Devera, Michael E

Devera, Michael E is an individual health care provider with primary practice located at 25865 Barton Road Suite 101, Loma Linda CA 92354. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Devera, Michael E can be contacted via phone (909) 558-3636.

Contact Information

Primary practice address
25865 Barton Road Suite 101 Loma Linda CA 92354
Fax: (909) 558-3722
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD053830L Pennsylvania

Profile Details

NPI number 1407829658
LBN Legal business name Devera, Michael E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jan 12th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407829658 NPPES
Pennsylvania MEDICAID 001886783

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