Healthcare Provider Details
I. General information
NPI: 1386731347
Provider Name (Legal Business Name): KARL LIMEWOOD EVELYN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/09/2006
Last Update Date: 09/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4020 5TH AVE
SAN DIEGO CA
92103-2106
US
IV. Provider business mailing address
23811 WASHINGTON AVE. C110 #340
MURRIETA CA
92562-2277
US
V. Phone/Fax
- Phone: 619-260-7022
- Fax: 619-260-7310
- Phone: 951-677-7205
- Fax: 951-677-7205
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | G33860 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: