Organization
LESLIE H EDRICH, M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE HOWARD EDRICH M.D. (OWNER)
(562) 427-9929
Entity
Organization
Contact information
Practice address
701 E 28TH ST, SUITE 400, LONG BEACH, CA 90806-2759
(562) 427-9929
(562) 427-2565
Mailing address
701 E 28TH ST, SUITE 400, LONG BEACH, CA 90806-2759
(562) 427-9929
(562) 427-2565
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G48000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G480000
—
CA
Enumeration date
03/08/2007
Last updated
07/28/2008
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