Individual
EVAN JAE BEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9339 GENESEE AVE STE 350A, SAN DIEGO, CA 92121-2119
(858) 263-0571
Mailing address
2285 CORPORATE CIR, STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
55344
CA
363A00000X
Physician Assistant
7083
AZ
Other
Enumeration date
02/20/2018
Last updated
03/11/2019
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