Provider Demographics
NPI:1740381383
Name:FAINSZTEIN, EVELYN (MD)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:FAINSZTEIN
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 PRAIRIE CITY RD
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-9594
Practice Address - Country:US
Practice Address - Phone:916-351-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA703042083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000810778253OtherPHCS
CA00A703040OtherBLUE SHIELD
CA1866716OtherFIRST HEALTH
CA2773899OtherCIGNA
CA00A70304Medicaid
CA082611OtherHEALTH NET
CAMCMG169200OtherWESTERN HEALTH ADVANTAGE
CA2027039OtherUNITED HEALTHCARE
CA254734OtherINTERPLAN
CA7771013OtherAETNA
CAA70304OtherBLUE CROSS
CA1392870OtherGREAT WEST
CA90118571OtherPACIFICARE
CA1866716OtherFIRST HEALTH
CA00A70304Medicaid