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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
Dermatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207N00000X
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Los Angeles, CA

All providers in Los Angeles, CA · Internal Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.