Provider Demographics
NPI:1386731347
Name:EVELYN, KARL LIMEWOOD (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:LIMEWOOD
Last Name:EVELYN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23811 WASHINGTON AVE.
Mailing Address - Street 2:C110 #340
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-2277
Mailing Address - Country:US
Mailing Address - Phone:951-677-7205
Mailing Address - Fax:951-677-7205
Practice Address - Street 1:4020 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2106
Practice Address - Country:US
Practice Address - Phone:619-260-7022
Practice Address - Fax:619-260-7310
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33860207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA91545Medicare UPIN
CAWG33860DMedicare ID - Type Unspecified
CA00G338600Medicare ID - Type Unspecified