Provider Demographics
NPI:1912012972
Name:PICKER, EVELYN S (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:S
Last Name:PICKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45280 SEELEY DR
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-6834
Mailing Address - Country:US
Mailing Address - Phone:760-610-7300
Mailing Address - Fax:
Practice Address - Street 1:45280 SEELEY DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-6834
Practice Address - Country:US
Practice Address - Phone:760-610-7300
Practice Address - Fax:760-610-7301
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA58041207R00000X
CAG137835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine