Organization
EVOLVED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA VELASCO (CEO)
(310) 927-0654
Entity
Organization
Contact information
Practice address
10573 W PICO BLVD UNIT 414, LOS ANGELES, CA 90064-2333
(310) 927-0654
Mailing address
10573 W PICO BLVD UNIT 414, LOS ANGELES, CA 90064-2333
(310) 927-0654
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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