Evyatar Evron MD Inc
Organization Active NPI Internal Medicine Physician · Los Angeles, CA
NPI 1114679446 · NPPES record last updated Oct 1, 2025
Key facts
- NPI
- 1114679446
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- EVYATAR EVRON MD INC
- Practice address
- 6222 Wilshire Blvd Ste 304
Los Angeles, CA 90048-5193 - Phone
- (310) 733-4171
- Fax
- (310) 559-0996
- NPI assigned
- Jan 18, 2022
- Organization subpart
- No
Authorized official
- Name
- Evyatar Evron, MD
- Title
- Ceo
- Phone
- (310) 733-4171
Practitioners 2
-
Evyatar Evron, MD
-
Pagiel Shechter, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230911002278 | CA | Part B Supplier - Clinic/Group Practice | 9537523402 |
Receives reassigned benefits from 1 practitioner Practice locations: Los Angeles, CA |
National Provider Directory
Locations
6222 Wilshire Blvd
Ste 304146
Los Angeles, CA 90048
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | |||
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
6222 Wilshire Blvd Ste 304
Los Angeles, CA 90048-5193
Mailing address
6612 Colgate Ave
Los Angeles, CA 90048-4205
Phone (310) 733-4171
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.