Individual
MR. ELLIS E. EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
869 NORTH CHERRY STREET, TULARE, CA 93274-2287
(559) 685-3450
(559) 685-3869
Mailing address
2550 N HOLLYWOOD WAY, SUITE 204, BURBANK, CA 91505-1055
(818) 557-0135
(818) 557-1394
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14524
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA14524
—
CA
Enumeration date
06/21/2006
Last updated
11/11/2008
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