Provider Demographics
NPI:1538426549
Name:WINOGRAD, EVAN KYLE (MD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:KYLE
Last Name:WINOGRAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 PASEO DEL NORTE STE 140
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1119
Mailing Address - Country:US
Mailing Address - Phone:470-663-4463
Mailing Address - Fax:
Practice Address - Street 1:6125 PASEO DEL NORTE STE 140
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1119
Practice Address - Country:US
Practice Address - Phone:470-663-4463
Practice Address - Fax:442-333-1277
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-15
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062471207T00000X
ORMD223385207T00000X
CAC200337207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery