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Individual

GEORGE KEITH EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1328 22ND ST, DEPARTMENT OF NUCLEAR MEDICINE, SANTA MONICA, CA 90404-2032
(310) 829-8229
(310) 449-9136
Mailing address
PO BOX 48904, LOS ANGELES, CA 90048-0904
(310) 449-1188
(310) 449-9136

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
G59625
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G596250
BLUE SHIELD
CA
05
00G596250
CA
Enumeration date
04/20/2006
Last updated
05/14/2008
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