Organization
EDGAR ARDILA MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR ARDILA MD (PHYSICIAN)
(951) 534-3158
Entity
Organization
Contact information
Practice address
11705 SLATE AVE, SUITE 200, RIVERSIDE, CA 92505-5196
(951) 351-1344
(951) 359-3748
Mailing address
28030 BLACKBERRY WAY, YORBA LINDA, CA 92887
(951) 351-1346
(951) 351-1346
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A54539
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A5453
—
CA
Enumeration date
01/26/2009
Last updated
10/27/2011
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