# J DAVID EDWARDS MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114232691
- **Authorized official:** DR. JOHN DAVID EDWARDS M.D. (PRESIDENT)
- **Authorized official phone:** (310) 828-8566

## Contact information

- **Practice address:** 2001 SANTA MONICA BLVD, SUITE 1265W, SANTA MONICA, CA 90404-2102
- **Practice address phone:** (310) 828-8566
- **Practice address fax:** (310) 453-9531
- **Mailing address:** 2001 SANTA MONICA BLVD, SUITE 1265W, SANTA MONICA, CA 90404-2102
- **Mailing address phone:** (310) 828-8566
- **Mailing address fax:** (310) 453-9531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | A26085 | CA | Yes |

## Other

- **Enumeration date:** 08/09/2010
- **Last updated:** 11/17/2010