Provider Demographics
NPI:1285883074
Name:MUSE, EVAN DAVID (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:DAVID
Last Name:MUSE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-824-5112
Mailing Address - Fax:858-964-3114
Practice Address - Street 1:9898 GENESEE AVE # AMP-400
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1205
Practice Address - Country:US
Practice Address - Phone:858-824-5112
Practice Address - Fax:858-964-3114
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122629207R00000X, 207RC0000X
MDD73179207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine