Provider Demographics
NPI:1962444703
Name:EVA, PEDRO
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:
Last Name:EVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3405
Mailing Address - Country:US
Mailing Address - Phone:808-372-6698
Mailing Address - Fax:
Practice Address - Street 1:147 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2809
Practice Address - Country:US
Practice Address - Phone:805-948-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD127572084P0800X
CAA902222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI56860201OtherALOHA CARE
HIMD12757OtherMDX HAWAII
HI00A0252609OtherQUEST HMSA
HI143961OtherUNIVERSITY HEALTH ALLIANC
HI990298651-96706-E056OtherTRICARE
HI568602Medicaid
HI00A0252609OtherHMSA
HI100636Medicare ID - Type Unspecified
HI56860201OtherALOHA CARE