Individual
EDWIN ENWIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 BRISTOL ST N STE 1B, NEWPORT BEACH, CA 92660
(949) 752-6300
Mailing address
9139 OAK ST, BELLFLOWER, CA 90706-4403
(562) 900-9345
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
—
—
363A00000X
Physician Assistant
Primary
PA55642
CA
Other
Enumeration date
06/05/2018
Last updated
10/15/2018
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