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Individual

DR. MICHAEL MARVIN EDELSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3460 RIDGEFORD DR, WESTLAKE VILLAGE, CA 91361-4818
(818) 707-9778
(818) 874-3655
Mailing address
3460 RIDGEFORD DR, WESTLAKE VILLAGE, CA 91361-4818
(818) 707-9778
(818) 874-3655

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G009107
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000G91070
BLUE SHIELD
CA
05
000G91070
CA
Enumeration date
10/12/2006
Last updated
02/06/2014
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