Individual
EDWARD THEODORE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 546-4062
(707) 578-6258
Mailing address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 546-4062
(707) 578-6258
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
A22103
CA
2085N0904X
Nuclear Radiology Physician
A22103
CA
2085R0202X
Diagnostic Radiology Physician
A22103
CA
2085U0001X
Diagnostic Ultrasound Physician
Primary
A22103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A221030
—
CA
Enumeration date
10/11/2006
Last updated
09/11/2025
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