Individual
EDWIN E DUPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4475
Mailing address
55799 FILE NUMBER, LOS ANGELES, CA 90074-5799
(800) 326-6223
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN340918
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN3409180
—
CA
Enumeration date
07/17/2006
Last updated
07/08/2007
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