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Organization

JOHN R EVANS MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN R EVANS MD (OWNER)
(909) 886-2609
Entity
Organization

Contact information

Practice address
399 E HIGHLAND AVE, SUITE 110, SAN BERNARDINO, CA 92404-3808
(909) 886-2609
Mailing address
399 E HIGHLAND AVE, SUITE 110, SAN BERNARDINO, CA 92404-3808
(909) 886-2609

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0051140
CA
Enumeration date
05/29/2008
Last updated
05/29/2008
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