Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A145182 | CA |
NPI | 1013395151 |
---|---|
Provider Name | Dr. Elizabeth Ann Bevins |
First Address | San Diego, CA 92193-2410 |
Second Address | La Jolla, CA 92037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2015 |
Last Update Date | 01/02/2021 |