Evergreen Care Medical

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

C04093 Issued in CA

Legal business name

EVERGREEN CARE MEDICAL

Practice address

900 W Olive Ave
Ste D
Merced, CA 95348-2429

Phone

(209) 723-2037

Fax

(209) 723-8767

NPI assigned

Mar 6, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raif Tawakol, M.D.

Title

Owner

Phone

(209) 723-2037

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1336319276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W OLIVE AVE",
            "address_2": "STE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482429",
            "telephone_number": "209-723-2037",
            "fax_number": "209-723-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W OLIVE AVE",
            "address_2": "STE D",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953482429",
            "telephone_number": "209-723-2037",
            "fax_number": "209-723-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CARE MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "TAWAKOL",
        "authorized_official_first_name": "RAIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-723-2037",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "C04093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Disease Physician in Merced, CA
• Providers in Merced, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.