MEDICARE: EVA XIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MT211736	PA
2	2085R0202X	Diagnostic Radiology Physician	A171533	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MT211736	OTHER	PA	PA LICENSE NUMBER

General Provider Information

NPI Number	:	1447609524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA XIA M.D.

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:	310-301-5138
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 WESTWOOD PLZ
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-3018
Country	:	US
Telephone Number	:	310-301-6800
Fax Number	:	310-794-9035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2016
Last Update Date	:	08/02/2021

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Directions to “ EVA XIA M.D.” Practice Location

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