Provider Demographics
NPI:1871297218
Name:EVIDENCE-BASED HEALTHCARE INC
Entity type:Organization
Organization Name:EVIDENCE-BASED HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:MONROE
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:TINKER
Authorized Official - Suffix:
Authorized Official - Credentials:AGACNP-BC
Authorized Official - Phone:917-623-0436
Mailing Address - Street 1:16267 BARNESTON ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3015
Mailing Address - Country:US
Mailing Address - Phone:917-623-0436
Mailing Address - Fax:
Practice Address - Street 1:16267 BARNESTON ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-3015
Practice Address - Country:US
Practice Address - Phone:917-623-0436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service