Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evan Guy Boulware Jackson, MD

Individual provider Hospitalist Physician · NPI 1194306118

Evan Guy Boulware Jackson, MD is a Hospitalist in Los Angeles, California. Graduated from Meharry Medical College School of Medicine in 2021, 5 years ago. Practices with The Regents of the University of California, a 1,414-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Trained at
Meharry Medical College School of Medicine
Licensed in
CA
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

757 Westwood Plz Ste 7501
Los Angeles, CA 90095-1029
Phone: (310) 267-9643
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1200 N State Street Clinic Tower, Los Angeles, CA 90033-1029 — (323) 409-7556

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence A196549 (CA)
Internal Medicine Physician Taxonomy 207R00000X · Licence A196549 (CA)

Record details

NPI number1194306118
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 20, 2021
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHOSPITALIST
Also practisesINTERNAL MEDICINE
Medical schoolMEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice The Regents Of The University Of California — 1414 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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