Individual
KEVAN EDWARD LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3800 JANES RD, ARCATA, CA 95521-4742
(707) 826-8264
Mailing address
1524 HORRELL ST, MCKINLEYVILLE, CA 95519-9467
(785) 851-8008
(707) 839-1044
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A82620
CA
Other
Enumeration date
05/04/2007
Last updated
08/10/2012
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