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General NPI Number Information
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NPI Number | 1538426549
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Entity Type | Individual
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Provider Name | EVAN KYLE WINOGRAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2012
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 6125 PASEO DEL NORTE STE 140
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City | CARLSBAD
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State | CA
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Zip | 92011-1119
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Country | US
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Telephone | 470-663-4463
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Fax | 442-333-1277
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Provider Business Mailing Address
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Address Line | 6125 PASEO DEL NORTE STE 140
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City | CARLSBAD
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State | CA
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Zip | 92011-1119
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Country | US
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Telephone | 470-663-4463
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Fax |
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | DR.0062471
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD223385
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | C200337
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License Number State | CA
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