| J Robert Evans Md Pc | |
|
355 E 21st St Ste H San Bernardino CA 92404-4851 | |
| (909) 886-2609 | |
| Not Available |
| Full Name | J Robert Evans Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 355 E 21st St Ste H, San Bernardino, California |
| Authorized Official Name and Position | J Robert Evans (OWNER) |
| Authorized Official Contact | 9097935511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J Robert Evans Md Pc 212 Summit Ave Redlands CA 92373-6852 Ph: (909) 793-5511 | J Robert Evans Md Pc 355 E 21st St Ste H San Bernardino CA 92404-4851 Ph: (909) 886-2609 |
| NPI Number | 1568928588 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 02/14/2019 |
| Medicare PECOS PAC ID | 5597091504 |
|---|---|
| Medicare Enrollment ID | O20190730000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568928588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | John R Evans |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245253582 PECOS PAC ID: 7214988898 Enrollment ID: I20050201001020 |
| Provider Name | Emily Ruth Bradford-lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205958840 PECOS PAC ID: 7315373354 Enrollment ID: I20200211000421 |
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