Provider Demographics
NPI:1619260270
Name:DENNIS U. EVANS, MD, INC.
Entity Type:Organization
Organization Name:DENNIS U. EVANS, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:U
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-649-1066
Mailing Address - Street 1:2100 GARDEN RD
Mailing Address - Street 2:BLD B, H-2
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5366
Mailing Address - Country:US
Mailing Address - Phone:831-649-1066
Mailing Address - Fax:831-649-5677
Practice Address - Street 1:2100 GARDEN RD
Practice Address - Street 2:BLD B, H-2
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5366
Practice Address - Country:US
Practice Address - Phone:831-649-1066
Practice Address - Fax:831-649-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG249192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty