EDWARD THEODORE EVANS M.D. NPI 1144319039

NPI Information

  • NPI: 1144319039
  • Provider Name: EDWARD THEODORE EVANS, M.D.
  • Classification: Radiology - 2085U0001X
  • Specialization: Diagnostic Ultrasound
  • Entity Type: Individual
  • Address: 121 SOTOYOME ST
    SANTA ROSA, CA
    ZIP 95405
  • Phone: (707) 546-4062

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NPI Details

Edward Theodore Evans, M.D. is a diagnostic ultrasound radiology in Santa Rosa, CA. The provider is a Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound. Edward Theodore Evans, M.D. NPI is 1144319039. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

121 SOTOYOME ST
SANTA ROSA, CA
ZIP 95405-823
Phone: (707) 546-4062
Fax: (707) 578-6258

The enumeration date for this NPI number is 10/11/2006 and was last updated on 9/11/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085B0100XRadiologyBody ImagingA22103CALIFORNIANo
22085N0904XRadiologyNuclear RadiologyA22103CALIFORNIANo
32085R0202XRadiologyDiagnostic RadiologyA22103CALIFORNIANo
42085U0001XRadiologyDiagnostic UltrasoundA22103CALIFORNIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100A221030MEDICAIDCALIFORNIA

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: 11/21/2025

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