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General NPI Number Information
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NPI Number | 1427518794
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Entity Type | Organization
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Legal Business Name | EVALONE PRO, LLC
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 1011 E DEVONSHIRE AVE STE 200
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City | HEMET
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State | CA
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Zip | 92543-3033
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Country | US
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Telephone | 626-471-1326
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Fax | 626-270-4409
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Provider Business Mailing Address
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Address Line | 1749 POTRERO GRANDE DR
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City | MONTEREY PARK
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State | CA
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Zip | 91755-5851
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Country | US
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Telephone | 626-471-1290
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Fax | 626-270-4409
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Authorized Official
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Title or Position | DIRECTOR OF OPS.
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Name | MR. SALVADOR AMARAL
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Credential |
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Telephone | 626-471-1290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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