Evans, Charles Wayne

Evans, Charles Wayne is an sole proprietor health care provider with primary practice located at 4704 Hoen Ave , Santa Rosa CA 95405-7824. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Evans, Charles Wayne can be contacted via phone (707) 546-7979.

Contact Information

Primary practice address
4704 Hoen Ave Santa Rosa CA 95405-7824
Phone: (707) 546-7979
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X G46087 California

Profile Details

NPI number 1073689766
LBN Legal business name Evans, Charles Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 27th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073689766 NPPES
California MEDICAID 00G460870

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