MEDICARE: DR. DORCAS MOURAY EAVES 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	207Q00000X	Family Medicine Physician	A33534	CA
2	208600000X	Surgery Physician	A33534	CA
3	208D00000X	General Practice Physician	A33534	CA
4	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	A33534	CA

General Provider Information

NPI Number	:	1962463901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DORCAS MOURAY EAVES M.D.

Provider Business Mailing Address
First Line	:	21351 EASTGLEN DR
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679-3365
Country	:	US
Telephone Number	:	949-636-5972
Fax Number	:	949-858-0957

Provider Business Practice Location Address
First Line	:	21351 EASTGLEN DR
Second Line	:
City	:	TRABUCO CANYON
State	:	CA
Zip	:	92679
Country	:	US
Telephone Number	:	949-636-5972
Fax Number	:	949-858-0957

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	05/15/2018

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