Individual
EDWARD A. BERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
79970 CEDAR CRST, LA QUINTA, CA 92253-5032
(760) 564-6383
(760) 564-6383
Mailing address
PO BOX 80099, CITY OF INDUSTRY, CA 91716-8099
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C27346
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C273460
BS
CA
05
—
00C273460
—
CA
01
—
P00374944
RR MC
CA
Enumeration date
07/18/2006
Last updated
10/25/2007
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