Individual
EDGAR M MADERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
410 N PAULINE ST, ANAHEIM, CA 92805-3058
(714) 420-9251
Mailing address
410 N PAULINE ST, ANAHEIM, CA 92805-3058
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
746975
CA
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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