Individual
JILBERT ERADAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10866 WILSHIRE BLVD, SUITE 400 - PMB 278, LOS ANGELES, CA 90024-4300
(310) 000-0000
Mailing address
631 W AVENUE Q, STE A, PALMDALE, CA 93551-3892
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A107977
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A107977
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A1079770
BCBS OF CA
CA
05
—
1083927115
—
CA
Enumeration date
07/19/2010
Last updated
08/21/2016
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