MR. MICHAEL TIMOTHY DEVEREUX (NPI# 1225217979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225217979 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL TIMOTHY DEVEREUX |
| Credential | PA-C |
| Practice Address |
11925 Main St Sunol CA 94586-9490 |
| Mailing Address |
Po Box 379 Sunol CA 94586-0379 |
| Practice Telephone | 9258622130 |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2014-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA12220 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144323668 | Michael J Devereux | Dentist | 2477 Oakmont Way, Eugene, OR 97401 | 2006-09-07 |
| Street Address |
11925 MAIN ST |
| City | SUNOL |
| State | CA |
| Zip Code | 94586-9490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841756541 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 227 Kilkare Rd, Sunol, CA 94586-9411 | 2019-02-18 |
| 1609388487 | Sunol Hills LLC | Psychiatric Residential Treatment Facility | 23 Carver Ln, Sunol, CA 94586-9441 | 2017-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841756541 | Monroe Operations, LLC | Substance Abuse Rehabilitation Facility | 227 Kilkare Rd, Sunol, CA 94586-9411 | 2019-02-18 |
| 1609388487 | Sunol Hills LLC | Psychiatric Residential Treatment Facility | 23 Carver Ln, Sunol, CA 94586-9441 | 2017-11-01 |
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.