Provider Demographics
NPI:1679921423
Name:AVA LABS, INC.
Entity Type:Organization
Organization Name:AVA LABS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CTO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-500-6865
Mailing Address - Street 1:1233 VIA DI SALERNO
Mailing Address - Street 2:APT 147
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-2111
Mailing Address - Country:US
Mailing Address - Phone:505-500-6865
Mailing Address - Fax:
Practice Address - Street 1:1233 VIA DI SALERNO
Practice Address - Street 2:APT 147
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-2111
Practice Address - Country:US
Practice Address - Phone:505-500-6865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty