Provider Demographics
NPI:1679927354
Name:EVANS, CHRISTINA TABIT (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:TABIT
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:JILL
Other - Last Name:TABIT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8274 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6821
Mailing Address - Country:US
Mailing Address - Phone:424-237-8406
Mailing Address - Fax:415-521-3057
Practice Address - Street 1:8274 MELROSE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-6821
Practice Address - Country:US
Practice Address - Phone:424-237-8406
Practice Address - Fax:415-521-3057
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA155422207V00000X
CA155422207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology