Individual
BRIAN D EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 GLASSON WAY, GRASS VALLEY, CA 95945-5723
(530) 274-6001
Mailing address
103 PROVIDENCE MINE RD, SUITE 202, NEVADA CITY, CA 95959-2941
(530) 470-8377
(530) 470-8906
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A67869
CA
208D00000X
General Practice Physician
A67869
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A678690
—
CA
Enumeration date
07/21/2005
Last updated
12/15/2010
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