Provider Demographics
NPI:1073755278
Name:KIRIMIS, EVANGELIA K (MD)
Entity Type:Individual
Prefix:DR
First Name:EVANGELIA
Middle Name:K
Last Name:KIRIMIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UCLA MEDICAL CENTER HEMATOLOGY ONCOLOGY
Mailing Address - Street 2:10945 LE CONTE AVE, 2333 PVUB
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-206-1214
Mailing Address - Fax:
Practice Address - Street 1:UCLA MEDICAL CENTER HEMATOLOGY ONCOLOGY
Practice Address - Street 2:10945 LE CONTE AVE, 2333 PVUB
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-206-1214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99632207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEZ838ZMedicare PIN