Provider Demographics
NPI:1679113096
Name:AVALOS, DAVID SALVADOR
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SALVADOR
Last Name:AVALOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2869
Mailing Address - Country:US
Mailing Address - Phone:619-232-9343
Mailing Address - Fax:
Practice Address - Street 1:3642 ROSA LINDA ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-3653
Practice Address - Country:US
Practice Address - Phone:619-250-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)