Provider Demographics
NPI:1972095693
Name:DAY, EVA (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:EVA
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 GLEASON ST
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5634
Mailing Address - Country:US
Mailing Address - Phone:951-520-8392
Mailing Address - Fax:
Practice Address - Street 1:1727 GLEASON ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-5634
Practice Address - Country:US
Practice Address - Phone:951-520-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant