Provider Demographics
NPI:1538338116
Name:EVELYN, CHRISTINE MCFADDEN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MCFADDEN
Last Name:EVELYN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91012-0003
Mailing Address - Country:US
Mailing Address - Phone:818-421-9971
Mailing Address - Fax:
Practice Address - Street 1:2025 ZONAL AVE
Practice Address - Street 2:HMR 711
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0110
Practice Address - Country:US
Practice Address - Phone:323-442-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20786207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41072Medicare UPIN