Organization
EDNA MA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA MA MD (DIRECT OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
607 N SIERRA BONITA AVE, LOS ANGELES, CA 90036-2404
(310) 657-6420
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A89373
CA
Other
Enumeration date
08/22/2011
Last updated
08/22/2011
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