Individual provider Active NPI

Eva Eckfeld Katz, M.D.

  • Family Medicine Physician
  • Tustin, CA
National Provider Identifier
1407936248
Registry record updated Jul 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A41445 Issued in CA
Practice address
1101 Bryan Ave
Ste E
Tustin, CA 92780-4401
Phone
(562) 981-2900
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A41445 CA Primary

Addresses

Primary practice location

1101 Bryan Ave
Ste E
Tustin, CA 92780-4401

Mailing address

1101 Bryan Ave
Ste E
Tustin, CA 92780-4401
Phone (949) 651-1475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120402000361 CA Practitioner - Family Practice 8628238482 Practice locations: Tustin, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41445CAMDDentist
A41445CAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499299200000",
    "number": "1407936248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BRYAN AVE",
            "address_2": "STE E",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804401",
            "telephone_number": "949-651-1475",
            "fax_number": "949-651-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 BRYAN AVE",
            "address_2": "STE E",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804401",
            "telephone_number": "562-981-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "EVA",
        "middle_name": "ECKFELD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A41445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.