MEDICARE: DR. EVA LEAN 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	2085R0001X	Radiation Oncology Physician	A42436	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487648572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVA LEAN M.D.

Provider Business Mailing Address
First Line	:	916 SYCAMORE AVE
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92081-7815
Country	:	US
Telephone Number	:	760-599-9545
Fax Number	:	760-599-9549

Provider Business Practice Location Address
First Line	:	916 SYCAMORE AVE
Second Line	:
City	:	VISTA
State	:	CA
Zip	:	92081-7815
Country	:	US
Telephone Number	:	760-599-9545
Fax Number	:	760-599-9549

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	04/09/2008

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Directions to “ DR. EVA LEAN M.D.” Practice Location

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