1134324403 NPI number — DR. PATRICIA L EVANS M.D.

Table of content: DR. PATRICIA L EVANS M.D. (NPI 1134324403)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134324403 NPI number — DR. PATRICIA L EVANS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EVANS
Provider First Name:
PATRICIA
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WELLS
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134324403
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 SUTTER ST FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94104-4009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-658-6791
Provider Business Mailing Address Fax Number:
415-520-0904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 G ST NW STE 200EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20001-4545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-660-0005
Provider Business Practice Location Address Fax Number:
202-660-0025
Provider Enumeration Date:
06/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD045591 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 0101243975 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)