# EDWARD H BESTARD M D INC

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

## Provider details

- **NPI number:** 1235432493
- **Authorized official:** MS. DEBORAH L WELLS (ASSISTANT OFFICE MANAGER)
- **Authorized official phone:** (949) 661-8817

## Contact information

- **Practice address:** 653 CAMINO DE LOS MARES, 102, SAN CLEMENTE, CA 92673-2808
- **Practice address phone:** (949) 661-8817
- **Practice address fax:** (949) 661-9033
- **Mailing address:** 653 CAMINO DE LOS MARES, 102, SAN CLEMENTE, CA 92673-2808
- **Mailing address phone:** (949) 661-8817
- **Mailing address fax:** (949) 661-9033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | G50298 | CA | Yes |

## Other

- **Enumeration date:** 12/09/2010
- **Last updated:** 04/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1396857769 | INDIVIDUAL NPI | — |