Healthcare Provider Details

I. General information

NPI: 1932159977
Provider Name (Legal Business Name): BRIAN N EVANS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7325 MEDICAL CENTER DR STE 304
WEST HILLS CA
91307
US

IV. Provider business mailing address

PO BOX 27206
LOS ANGELES CA
90027-0206
US

V. Phone/Fax

Practice location:
  • Phone: 818-665-8535
  • Fax:
Mailing address:
  • Phone: 213-385-0675
  • Fax: 213-365-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA70983
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: