Active NPI
Eric Cuarto Evangelista, PA
- Physician Assistant
- Long Beach, CA
National Provider Identifier
1124426234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 52190
- Practice address
- 1007 E Freeland St
Long Beach, CA 90807-1652 - Phone
- (562) 394-3347
- NPI assigned
- Dec 5, 2014
- Last updated
- Jan 12, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 52190 | CA | Primary |
Addresses
Primary practice location
1007 E Freeland St
Long Beach, CA 90807-1652
Mailing address
10400 Rancho Rd
Adelanto, CA 92301-2237
Phone (760) 561-6100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52190 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452556800000",
"number": "1124426234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10400 RANCHO RD",
"city": "ADELANTO",
"state": "CA",
"postal_code": "923012237",
"telephone_number": "760-561-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 E FREELAND ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908071652",
"telephone_number": "562-394-3347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANGELISTA",
"first_name": "ERIC",
"middle_name": "CUARTO",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-05",
"last_updated": "2016-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "52190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.