Individual
MR. BRIAN DAVID EVELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDCC
Contact information
Practice address
737 E GRAND AVE, ESCONDIDO, CA 92025-4404
(760) 745-9485
(760) 745-6852
Mailing address
737 E GRAND AVE, ESCONDIDO, CA 92025-4404
(760) 745-9485
(760) 745-6852
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
R1361190819
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R1361190819
MEDI-CAL
CA
Enumeration date
11/02/2019
Last updated
06/28/2023
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