Provider Demographics
NPI:1912201716
Name:THOMAS, EVELYAN LOUISE PATTERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:EVELYAN
Middle Name:LOUISE PATTERSON
Last Name:THOMAS
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:PO BOX 1145
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-0361
Mailing Address - Country:US
Mailing Address - Phone:909-792-7973
Mailing Address - Fax:909-792-1512
Practice Address - Street 1:1332 CRESTVIEW RD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-6323
Practice Address - Country:US
Practice Address - Phone:909-792-7973
Practice Address - Fax:909-792-1512
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20791174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator