Ellis E. Evans, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14524 Issued in CA

Practice address

869 North Cherry Street
Tulare, CA 93274-2287

Phone

(559) 685-3450

Fax

(559) 685-3869

NPI assigned

Jun 21, 2006

Last updated

Nov 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226361600000",
    "number": "1679519268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 N HOLLYWOOD WAY",
            "address_2": "SUITE 204",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915051055",
            "telephone_number": "818-557-0135",
            "fax_number": "818-557-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 NORTH CHERRY STREET",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932742287",
            "telephone_number": "559-685-3450",
            "fax_number": "559-685-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ELLIS",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA14524",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Esqueda
• Tiffany Esry
• Edith G Esteban, LVN
• Monica Evangelista
• Brian Thomas Evans, R.D.M.S.
• Thomas R Evans, M.D.
• Emmanuel Torrefiel Fabella, MD
• Leah Fallis, LMFT
• Family Healthcare Network
• Family Healthcare Network

• Physician Assistant in Tulare, CA
• Providers in Tulare, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.