Evertson, Leslie Chang

Evertson, Leslie Chang is an individual health care provider with primary practice located at 1245 16Th St Suite 208, Santa Monica CA 90404-1235. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Evertson, Leslie Chang can be contacted via phone (310) 825-8253.

Contact Information

Primary practice address
1245 16Th St Suite 208 Santa Monica CA 90404-1235
Fax: (310) 319-4141
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 16341 California

Profile Details

NPI number 1235141078
LBN Legal business name Evertson, Leslie Chang
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated Feb 28th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235141078 NPPES
California MEDICAID 1235141078

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