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KERRY B EVNIN MD INC A PROFESSIONAL MEDICAL CORPORATION NPI 1902855588


NPI Information

NPI: 1902855588
Provider Name: KERRY B EVNIN MD INC A PROFESSIONAL MEDICAL CORPORATION
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
3641 MITCHELL RD
H
CERES, CA
ZIP 95307
Phone: (209) 531-0154
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KERRY B EVNIN MD INC A PROFESSIONAL MEDICAL CORPORATION is a family medicine in Ceres, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KERRY B EVNIN MD INC A PROFESSIONAL MEDICAL CORPORATION NPI is 1902855588. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3641 MITCHELL RD
H
CERES, CA
ZIP 95307
Phone: (209) 531-0154
Fax: (209) 531-0176

The provider's authorized official is Kerry B Evnin .
The authorized official title is President and has the following contact phone number (209) 531-0154.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 6/29/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine655240CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A52907MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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