Healthcare Provider Details

I. General information

NPI: 1881598027
Provider Name (Legal Business Name): DANIEL JAMES EVANS REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 CADILLAC AVE
LOS ANGELES CA
90034-1702
US

IV. Provider business mailing address

75 VIA COLINAS
WESTLAKE VILLAGE CA
91362-5003
US

V. Phone/Fax

Practice location:
  • Phone: 323-857-2393
  • Fax:
Mailing address:
  • Phone: 626-390-2166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95126114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: