Healthcare Provider Details

I. General information

NPI: 1821300518
Provider Name (Legal Business Name): DARCI EVANS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W CARSON ST DEPARTMENT OF PEDIATRICS
TORRANCE CA
90509-2004
US

IV. Provider business mailing address

1000 W CARSON ST BOX 491, DEPARTMENT OF PEDIATRICS
TORRANCE CA
90509-2004
US

V. Phone/Fax

Practice location:
  • Phone: 424-306-5600
  • Fax:
Mailing address:
  • Phone: 424-306-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A11889
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number20A11889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: