Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gregory Avetisov, DO

Individual provider Family Medicine Physician · NPI 1679917280

Gregory Avetisov, DO is a General Practice in Lincoln, California. Qualified in 2017, 9 years ago. Licensed in California and Florida.

Years since qualifying
9
Licensed in
CA, FL
In the registry since
2013
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

2641 Miller Run Ln
Lincoln, CA 95648-7545
Phone: (209) 754-6262
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 20A22510 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 17139 (FL)

Record details

NPI number1679917280
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 25, 2013
Last updated in NPPESJune 1, 2026
Certification dateJune 1, 2026
Mailing addressPo Box 939, Angels Camp, CA 95222-0939

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Lincoln