Provider Demographics
NPI:1285798033
Name:WILLIAM C EVES M D INC
Entity type:Organization
Organization Name:WILLIAM C EVES M D INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:EVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-409-3600
Mailing Address - Street 1:480 4TH AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4410
Mailing Address - Country:US
Mailing Address - Phone:619-426-3240
Mailing Address - Fax:619-426-5964
Practice Address - Street 1:480 4TH AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4410
Practice Address - Country:US
Practice Address - Phone:619-426-3240
Practice Address - Fax:619-426-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65653207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA65653OtherMEDICAL LICENSE
CAH60444Medicare UPIN
CAA65653OtherMEDICAL LICENSE