Provider Demographics
NPI:1760607410
Name:L.EVANS MD, INC
Entity Type:Organization
Organization Name:L.EVANS MD, INC
Other - Org Name:SALVIA CANYON PRIMARY CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-354-7316
Mailing Address - Street 1:466 FOOTHILL BLVD
Mailing Address - Street 2:#115
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3518
Mailing Address - Country:US
Mailing Address - Phone:626-354-7316
Mailing Address - Fax:626-744-1522
Practice Address - Street 1:418 N FAIR OAKS AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3659
Practice Address - Country:US
Practice Address - Phone:626-605-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty