Active NPI
Evelyn Giselle Gomez, PA-C
- Medical Physician Assistant
- Anaheim, CA
National Provider Identifier
1437464807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA20871
- Practice address
- 1211 W la Palma Ave
Suite #707
Anaheim, CA 92801-2815 - Phone
- (724) 776-2100
- Fax
- (714) 776-1960
- NPI assigned
- Aug 10, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA20871 | CA | Primary |
Addresses
Primary practice location
1211 W la Palma Ave
Suite #707
Anaheim, CA 92801-2815
Mailing address
1211 W la Palma Ave
Suite #707
Anaheim, CA 92801-2815
Phone (724) 776-2100
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA20871 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281398400000",
"number": "1437464807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 W LA PALMA AVE",
"address_2": "SUITE #707",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012815",
"telephone_number": "724-776-2100",
"fax_number": "714-776-1960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 W LA PALMA AVE",
"address_2": "SUITE #707",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928012815",
"telephone_number": "724-776-2100",
"fax_number": "714-776-1960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "EVELYN",
"middle_name": "GISELLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-10",
"last_updated": "2010-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA20871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.