Provider Demographics
NPI:1104871227
Name:EVANS, TOMI (MD)
Entity type:Individual
Prefix:DR
First Name:TOMI
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E 28TH ST
Mailing Address - Street 2:SUITE 411
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2759
Mailing Address - Country:US
Mailing Address - Phone:562-426-0338
Mailing Address - Fax:562-427-7766
Practice Address - Street 1:701 E 28TH ST
Practice Address - Street 2:SUITE 411
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2759
Practice Address - Country:US
Practice Address - Phone:562-426-0338
Practice Address - Fax:562-427-7766
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51873174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist