Individual
EVADNA T NESBIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
12021 WILSHIRE BLVD, LOS ANGELES, CA 90025-1206
(866) 968-6380
(310) 445-6622
Mailing address
12021 WILSHIRE BLVD, LOS ANGELES, CA 90025-1206
(866) 968-6380
(866) 986-6380
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
67564
CA
363A00000X
Physician Assistant
Primary
PA14380
CA
Other
Enumeration date
04/10/2007
Last updated
08/04/2015
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