Individual
EDITH REANTILLO ECHIVERRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3160 GENEVA STEET, LOS ANGELES, CA 90020
(213) 368-3338
Mailing address
6401 N VISTA ST, SAN GABRIEL, CA 91775-1830
(626) 285-8373
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A34803
CA
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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