Provider Demographics
NPI:1891810404
Name:EVANS, DENNIS U (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:U
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 GARDEN RD
Mailing Address - Street 2:BUILDING B, SUITE 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:BUILDING B, SUITE 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
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG249192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G249190Medicare ID - Type Unspecified
CAA42444Medicare UPIN