| Evan Gordon-wollin Do | |
|
8700 Beverly Blvd West Hollywood CA 90048-1804 | |
| (562) 833-4819 | |
| Not Available |
| Full Name | Evan Gordon-wollin Do |
|---|---|
| Speciality | Internal Medicine |
| Location | 8700 Beverly Blvd, West Hollywood, California |
| Authorized Official Name and Position | Evan Ross Gordon-wollin (PRESIDENT) |
| Authorized Official Contact | 5628334819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Gordon-wollin Do 357 S Curson Ave Apt 12m Los Angeles CA 90036-5276 Ph: () - | Evan Gordon-wollin Do 8700 Beverly Blvd West Hollywood CA 90048-1804 Ph: (562) 833-4819 |
| NPI Number | 1710747175 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 03/21/2024 |
| Medicare PECOS PAC ID | 6507207081 |
|---|---|
| Medicare Enrollment ID | O20240515001599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710747175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Evan Ross Gordon-wollin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548616873 PECOS PAC ID: 9739411778 Enrollment ID: I20191024001941 |
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