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General NPI Number Information
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NPI Number | 1235142761
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Entity Type | Individual
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Provider Name | EVELYN EVENS LI M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 12/02/2016
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Provider Practice Location Address
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Address Line | 46356 WARM SPRINGS BLVD 872
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City | FREMONT
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State | CA
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Zip | 94539-7021
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Country | US
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Telephone | 510-770-1300
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Fax | 510-573-4811
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Provider Business Mailing Address
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Address Line | PO BOX 14858
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City | FREMONT
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State | CA
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Zip | 94539
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Country | US
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Telephone | 510-770-1300
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Fax | 510-573-4811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G48660
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License Number State | CA
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