Provider Demographics
NPI:1508023318
Name:AVANES, EMIL (MD)
Entity Type:Individual
Prefix:
First Name:EMIL
Middle Name:
Last Name:AVANES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 N VERDUGO RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1676
Mailing Address - Country:US
Mailing Address - Phone:818-369-7470
Mailing Address - Fax:818-369-7471
Practice Address - Street 1:3217 N VERDUGO RD STE 1
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1676
Practice Address - Country:US
Practice Address - Phone:818-369-7470
Practice Address - Fax:818-369-7471
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110814207R00000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist