Individual
EVAN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 W LEGION RD, BRAWLEY, CA 92227-7780
(760) 351-3333
Mailing address
2461 STARLIGHT GLN, ESCONDIDO, CA 92026-3858
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA63931
CA
Other
Enumeration date
10/30/2023
Last updated
01/19/2024
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