Individual
EDWARD KONDROT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15230 LAKESHORE DR, CLEARLAKE, CA 95422-8107
(707) 995-4518
(707) 995-4526
Mailing address
15230 LAKESHORE DR, CLEARLAKE, CA 95422-8107
(707) 995-4518
(707) 995-4526
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G89041
CA
207W00000X
Ophthalmology Physician
MD021475E
PA
Other
Enumeration date
08/30/2020
Last updated
01/06/2026
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