Provider Demographics
NPI:1104884121
Name:VEVAINA, JAMES R (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:VEVAINA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8929 UNIVERSITY CENTER LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1006
Mailing Address - Country:US
Mailing Address - Phone:858-581-0400
Mailing Address - Fax:858-581-0070
Practice Address - Street 1:8929 UNIVERSITY CENTER LN
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1006
Practice Address - Country:US
Practice Address - Phone:858-581-0400
Practice Address - Fax:858-581-0070
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2011-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA30551207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A305510Medicaid
CAB17953Medicare UPIN
CA00A305510Medicaid