Organization
CORYDON G EDGECOMB OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORYDON EDGECOMB O.D. (DOCTOR)
(530) 622-7660
Entity
Organization
Contact information
Practice address
1287 BROADWAY, PLACERVILLE, CA 95667-5820
(530) 622-7660
(530) 622-3753
Mailing address
1287 BROADWAY, PLACERVILLE, CA 95667-5820
(530) 622-7660
(530) 622-3753
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 4245 TPA
CA
Other
Enumeration date
02/02/2011
Last updated
03/21/2011
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