Individual
DR. GREGORY E EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
71956 MAGNESIA FALLS DR, RANCHO MIRAGE, CA 92270-4901
(760) 674-8806
(760) 674-8826
Mailing address
71956 MAGNESIA FALLS DR, RANCHO MIRAGE, CA 92270-4901
(760) 674-8806
(760) 674-8826
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6648TLG
CA
152W00000X
Optometrist
6648TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6648TPL
STATE LICENSE
CA
Enumeration date
06/22/2006
Last updated
04/09/2018
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