Individual
EDGAR ARDILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11705 SLATE AVE, SUITE 200, RIVERSIDE, CA 92505-5196
(951) 351-1346
(951) 359-3748
Mailing address
28030 BLACKBERRY WAY, YORBA LINDA, CA 92887-5803
(714) 692-5180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A54539
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
A54539
CA
207RP1001X
Pulmonary Disease Physician
A54539
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A545391
—
CA
Enumeration date
08/31/2005
Last updated
12/15/2011
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