Individual
TRAVIS EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 IMPERIAL HWY, DOWNEY, CA 90242-3456
(562) 385-7713
Mailing address
4025 SW CONDOR AVE, PORTLAND, OR 97239-4172
(541) 740-8978
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
165566
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2014
Last updated
09/20/2019
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