Provider Demographics
NPI:1598254096
Name:AVILA, OSCAR F (ATC)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:F
Last Name:AVILA
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 S ALEXANDRIA AVE APT 216
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-2670
Mailing Address - Country:US
Mailing Address - Phone:541-829-8453
Mailing Address - Fax:
Practice Address - Street 1:345 S ALEXANDRIA AVE APT 216
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-2670
Practice Address - Country:US
Practice Address - Phone:541-829-8453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer