Active NPI
Michele Lynn Evans, M.D.
- Reproductive Endocrinology Physician
- Glendale, CA
National Provider Identifier
1699745257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reproductive Endocrinology Physician
- License
- A62219
- Practice address
- 1808 Verdugo Blvd
Suite 319
Glendale, CA 91208 - Phone
- (626) 440-9161
- Fax
- (626) 585-1603
- NPI assigned
- Jan 25, 2006
- 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 |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | A62219 | CA | Primary |
Addresses
Primary practice location
1808 Verdugo Blvd
Suite 319
Glendale, CA 91208
Mailing address
1808 Verdugo Blvd
Suite 319
Glendale, CA 91208
Phone (818) 952-0328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A62219 | Other | CA | MEDICAL LICENSE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A62219 | CA | MD | Reproductive Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Fertility Center | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ambulatory Fertility Facility
- Los Angeles, CA
- NPI 1407244767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395964800000",
"number": "1699745257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1808 VERDUGO BLVD",
"address_2": "SUITE 319",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91208",
"telephone_number": "818-952-0328",
"fax_number": "818-952-0365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 VERDUGO BLVD",
"address_2": "SUITE 319",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91208",
"telephone_number": "626-440-9161",
"fax_number": "626-585-1603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "MICHELE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2014-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "CA",
"license": "A62219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "A62219",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.