Active NPI
Harun Evcimen, M.D.
- Psychiatry Physician
- San Quentin, CA
National Provider Identifier
1760636864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D66971
- Practice address
- 1 Main St. H-Unit Yard Tele Psychiatry
CDCR San Quetin State Prison
San Quentin, CA 94964 - Phone
- (415) 454-1460
- NPI assigned
- Nov 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D66971 | MD | Primary |
| Psychiatry Physician | 2084P0800X | A119563 | CA | |
| Psychiatry Physician | 2084P0800X | MD442724 | PA |
Addresses
Primary practice location
1 Main St. H-Unit Yard Tele Psychiatry
CDCR San Quetin State Prison
San Quentin, CA 94964
Mailing address
1 Main St. H-Unit Yard Tele Psychiatry
CDCR San Quetin State Prison
San Quentin, CA 94964
Phone (415) 454-1460
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A119563 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Shore Community Mental Health Ctr | Past | Accepting new patients | |
| State of Maryland Central Payroll Bureau | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Skilled Nursing Facility
- Charlotte Hall, MD
- NPI 1356032734
-
- Psychiatric Hospital
- Chestertown, MD
- NPI 1841345402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1760636864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MAIN ST. H-UNIT YARD TELE PSYCHIATRY",
"address_2": "CDCR SAN QUETIN STATE PRISON",
"city": "SAN QUENTIN",
"state": "CA",
"postal_code": "94964",
"telephone_number": "415-454-1460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MAIN ST. H-UNIT YARD TELE PSYCHIATRY",
"address_2": "CDCR SAN QUETIN STATE PRISON",
"city": "SAN QUENTIN",
"state": "CA",
"postal_code": "94964",
"telephone_number": "415-454-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVCIMEN",
"first_name": "HARUN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-17",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D66971",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A119563",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD442724",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Quentin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.