Individual
EVAN CHISUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4001 J ST, SACRAMENTO, CA 95819-3626
(330) 493-4443
Mailing address
150 CASHMAN CIR, SACRAMENTO, CA 95835-1606
(916) 419-8841
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A78813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A788130
—
CA
Enumeration date
02/08/2007
Last updated
06/20/2013
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