Search › California › 101YM0800X
Jonathan Evanculla
NPI 1740840214 · on the registry since 2019
Practice
- Address
- 4211 Avalon Blvd
Los Angeles, CA 90011 - Phone
- (323) 233-0425
- Organisation at this address
- Kedren Health
Prime Pharmacy Services Inc
Kedren Community Care Clinic - B
Kedren Acute Psychiatric Hospital
Kedren Integrated Care System, Inc.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 351
Additional practice sites
- 333 S Beaudry Ave, Los Angeles, CA
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Also registered as
- 1041C0700X
390200000X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-08-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California